Dealing with dying – progressing paramedics’ role in grief support

Cameron, Cheryl; Lunn, Tyne M.; Lanos, Chelsea; Batt, Alan M

doi:10.1080/09699260.2020.1856634

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…However, findings from a 2021 study recognise existing education and system resources have largely failed to provide paramedics with the necessary tools to provide grief support to family members and others who are suddenly bereaved following a palliative emergency. 49 Increasing paramedics' comfort and capacity for providing grief support, in addition to other core palliative care skills, will require an array of educational methodologies. Innovative models that focus on enabling paramedics to broaden their role as emergency clinicians providing community-based palliative and end-of-life care are already emerging.…”

Section: Discussionmentioning

confidence: 99%

Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis

et al. 2021

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Background: There is a growing demand for community palliative care and home-based deaths worldwide. However, gaps remain in this service provision, particularly after-hours. Paramedicine may help to bridge that gap and avoid unwanted hospital admissions, but a systematic overview of paramedics’ potential role in palliative and end-of-life care is lacking. Aim: To review and synthesise the empirical evidence regarding paramedics delivering palliative and end-of-life care in community-based settings. Design: A systematic integrative review with a thematic synthesis was undertaken in accordance with Whittemore and Knafl’s methodology. Prospero: CRD4202119851. Data sources: MEDLINE, CINAHL, PsycINFO and Scopus databases were searched in August 2020 for primary research articles published in English, with no date limits applied. Articles were screened and reviewed independently by two researchers, and quality appraisal was conducted following the Mixed-Methods Appraisal Tool (2018). Results: The search retrieved 5985 articles; 23 articles satisfied eligibility criteria, consisting of mixed-methods ( n = 5), qualitative ( n = 7), quantitative descriptive ( n = 8) and quantitative non-randomised studies ( n = 3). Through data analysis, three key themes were identified: (1) Broadening the traditional role, (2) Understanding patient wishes and (3) Supporting families. Conclusions: Paramedics are a highly skilled workforce capable of helping to deliver palliative and end-of-life care to people in their homes and reducing avoidable hospital admissions, particularly for palliative emergencies. Future research should focus on investigating the efficacy of palliative care clinical practice guideline implementation for paramedics, understanding other healthcare professionals’ perspectives, and undertaking health economic evaluations of targeted interventions.

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Section: Discussionmentioning

confidence: 99%

Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis

et al. 2021

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“…Future research ought to investigate all stakeholders’ perspectives to better inform practice related to care after death. Literature supports the need for soft skills communication training for paramedics to initiate advance care planning, 49 break bad news 50 and discuss end-of-life matters 48 ; a gap that has only been reinforced by the broadening role of paramedics providing grief support during the COVID-19 pandemic. 51…”

Section: Discussionmentioning

confidence: 99%

“…Future research ought to investigate all stakeholders' perspectives to better inform practice related to care after death. Literature supports the need for soft skills communication training for paramedics to initiate advance care planning, 49 break bad news 50 and discuss end-of-life matters 48 ; a gap that has only been reinforced by the broadening role of paramedics providing grief support during the COVID-19 pandemic. 51 Findings from our study have the potential to shape future policy and practice, identifying the need to broaden palliative care beyond a specialised role, remove restrictions on prerequisite services required to apply a palliative approach, invest in integrated models of care and address care after death.…”

Section: Discussionmentioning

confidence: 99%

Palliative paramedicine: Comparing clinical practice through guideline quality appraisal and qualitative content analysis

et al. 2022

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Background: Palliative care is an emerging scope of practice for paramedicine. The COVID-19 pandemic has highlighted the opportunity for emergency settings to deliver palliative and end-of-life care to patients wishing to avoid intensive life-sustaining treatment. However, a gap remains in understanding the scope and limitations of current ambulance services’ approach to palliative and end-of-life care. Aim: To examine the quality and content of existing Australian palliative paramedicine guidelines with a sample of guidelines from comparable Anglo-American ambulance services. Design: We appraised guideline quality using the AGREE II instrument and employed a collaborative qualitative approach to analyse the content of the guidelines. Data sources: Eight palliative care ambulance service clinical practice guidelines (five Australian; one New Zealand; one Canadian; one United Kingdom). Results: None of the guidelines were recommended by both appraisers for use based on the outcomes of all AGREE II evaluations. Scaled individual domain percentage scores varied across the guidelines: scope and purpose (8%–92%), stakeholder involvement (14%–53%), rigour of development (0%–20%), clarity of presentation (39%–92%), applicability (2%–38%) and editorial independence (0%–38%). Six themes were developed from the content analysis: (1) audience and approach; (2) communication is key; (3) assessing and managing symptoms; (4) looking beyond pharmaceuticals; (5) seeking support; and (6) care after death. Conclusions: It is important that ambulance services’ palliative and end-of-life care guidelines are evidence-based and fit for purpose. Future research should explore the experiences and perspectives of key palliative paramedicine stakeholders. Future guidelines should consider emerging evidence and be methodologically guided by AGREE II criteria.

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“…This fear is sometimes associated with Do Not Attempt Resuscitation orders (DNAR) as sometimes (1) the order cannot be accessed, (2) they do not understand the legal requirements associated with DNAR, or (3) whose responsibility is it to discuss the DNAR with the patient and families. 5 It has also been found that the paramedics convey dying patients to hospital despite patients having advance care plans or being known to community palliative care teams and previously expressing a wish to avoid an acute hospital admission. 6 Another hurdle for paramedics is that the patient documentation available in the home is often out of date, inconsistent and limited which can lead to lack of confidence when caring for dying patients in expected deaths.…”

Section: Paramedics Providing Palliative and End Of Life Carementioning

confidence: 99%

What is the role of paramedics in palliative and end of life care?

Blackmore

2022

Palliat Med

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Dealing with dying – progressing paramedics’ role in grief support

Cited by 4 publications

References 27 publications

Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis

Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis

Palliative paramedicine: Comparing clinical practice through guideline quality appraisal and qualitative content analysis

What is the role of paramedics in palliative and end of life care?

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