Australian residential aged care home staff experiences of implementing an intervention to improve palliative and end‐of‐life care for residents: A qualitative study

Nagarajan, Srivalli; Poulos, Christopher J.; Clayton, Josephine M.; Atee, Mustafa; Morris, Thomas; Lovell, Melanie

doi:10.1111/hsc.13984

Cited by 5 publications

(2 citation statements)

References 49 publications

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“…Of the 2530 retrieved studies, 193 were ultimately included 6,7,11–201 . The PRISMA-ScR diagram (Figure 1) shows the study selection process and reasons for full-text exclusion.…”

Section: Resultsmentioning

confidence: 99%

Factors that influence the implementation of innovation in aged care: a scoping review

Windle,

Marshall,

de la Perrelle

et al. 2023

JBI Evidence Implementation

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Objective: The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care. Introduction: Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared to health care. Inclusion criteria: This review included studies of any design, that examined the implementation of innovations in aged care settings. Methods: Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine inclusion. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories in a series of workshops. Results: Of the 2530 studies that were screened, 193 were included. Of the included papers, the majority (74%) related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions such as stakeholder engagement and implementation strategies. Conclusions: Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care, and greater engagement with theory and community is needed to promote research rigor, relevance and applicability.

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“…Of the 2530 retrieved studies, 193 were ultimately included 6,7,11–201 . The PRISMA-ScR diagram (Figure 1) shows the study selection process and reasons for full-text exclusion.…”

Section: Resultsmentioning

confidence: 99%

Factors that influence the implementation of innovation in aged care: a scoping review

Windle,

Marshall,

de la Perrelle

et al. 2023

JBI Evidence Implementation

View full text Add to dashboard Cite

show abstract

“…This phenomenon has led to long-term care facilities often becoming the places where elderly individuals with chronic illnesses and dementia spend their final stages of life. [1][2][3][4] Residents in these long-term care facilities typically suffer from various life-threatening diseases, leading to diverse palliative care needs. Palliative care, distinct from general medical treatment, considers death as a normal process.…”

Section: Introductionmentioning

confidence: 99%

The Experiences of Nursing Managers in Implementing Palliative Care in Long-Term Care Facilities

Chiang,

Lu,

et al. 2023

JMDH

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The purpose of this study was to explore the experiences of nursing managers in implementing palliative care in long-term care facilities and to provide recommendations for managers who plan to introduce palliative care into their facilities. Methods: This study used semi-structured interviews and grounded theory methodology, with purposive sampling. A total of 11 longterm care facilities in eastern Taiwan that had implemented palliative care were selected, and 11 facility nursing managers participated in in-depth, face-to-face interviews. Results:The introduction of palliative care in long-term care facilities can be divided into four stages: (1) the opportunity for change, (2) playing a supportive role, ( 3) a new collaboration model, and (4) facility transformation. The core category shared by the participants may be summed up as "the palliative care captain in the facility". It reflects the spirit of the successful implementation of palliative care by managers in long-term care facilities. Conclusion:The study reveals that during the initial phases of implementing palliative care, the palliative care teams assume a crucial leadership role, while the facilities play a supportive role. At this stage, managers should focus on personnel training and addressing internal issues within the facilities to facilitate successful collaboration with the palliative care teams. In the later stages, the facilities transition from a supportive role to one of independence, marking a critical juncture for the facilities' potential stable development. During this period, managers are tasked not only with establishing the facilities' own palliative care team but also with facilitating the transformation of staff from learners to instructors. Finally, even after successful implementation, managers must contemplate how to innovate and set more ambitious goals.

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Australian residential aged care home staff experiences of implementing an intervention to improve palliative and end‐of‐life care for residents: A qualitative study

Nagarajan

Poulos

Clayton

et al. 2022

Health Social Care Comm

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Access to high-quality and safe evidence-based palliative care (PC) is important to ensure good end-of-life care for older people in residential aged care homes (RACHs). However, many barriers to providing PC in RACHs are frequently cited. The Quality End-of-Life Care (QEoLC) Project was a multicomponent intervention that included training, evidencebased tools and tele-mentoring, aiming to equip healthcare professionals and careworkers in RACHs with knowledge, skills and confidence in providing PC to residents. This study aims to understand: (1) the experiences of healthcare professionals, careworkers, care managers, planners/implementers who participated in the implementation of the QEoLC Project; and (2) the barriers and facilitators to the implementation. Staff from two RACHs in New South Wales, Australia were recruited between September to November 2021.Semi-structured interviews and thematic data analysis were used. Fifteen participants (seven health professionals [includes one nurse, two clinical educators, three workplace trainers, one clinical manager/nurse], three careworkers and five managers) were interviewed. Most RACH participants agreed that the QEoLC Project increased their awareness of PC and provided them with the skills/confidence to openly discuss death and dying. Participants perceived that the components of the QEoLC Project had the following benefits for residents: more appropriate use of medications, initiation of timely pain management and discussions with families regarding end-of-life care preferences. Key facilitators for implementation were the role of champions, the role of the steering committee, regular clinical meetings to discuss at-risk residents and mentoring. Implementation barriers included: high staff turnover, COVID-19 pandemic, time constraints, perceived absence of executive sponsorship, lack of practical support and systems-related barriers. The findings underline the need for strong leadership, supportive organisational culture and commitment to the implementation of processes for improving the quality of end-of-lifeThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Australian residential aged care home staff experiences of implementing an intervention to improve palliative and end‐of‐life care for residents: A qualitative study

Cited by 5 publications

References 49 publications

Factors that influence the implementation of innovation in aged care: a scoping review

Factors that influence the implementation of innovation in aged care: a scoping review

The Experiences of Nursing Managers in Implementing Palliative Care in Long-Term Care Facilities

Australian residential aged care home staff experiences of implementing an intervention to improve palliative and end‐of‐life care for residents: A qualitative study

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