Implementation of palliative care educational intervention in long-term care: a qualitative multi-perspective investigation

Abstract

In industrialised countries, a large number of older adults with increasingly complex end of life care needs will die while in longterm care. It is essential that processes be in place to facilitate quality end of life care in these settings. In collaboration with two local hospices over the course of one year, we developed a new model of palliative care within long-term care-Supportive Hospice Aged Residential Exchange (SHARE). SHARE fostered knowledge exchange between hospice nurses and long-term care staff to improve palliative care delivery within 20 long-term care facilities (LTCF's). An in-depth qualitative investigation of the views of 59 healthcare professionals and 12 bereaved family members of residents, regarding SHARE implementation, was undertaken through semi-structured interviews. Transcripts were analysed thematically and mapped to the theoretical domains framework (TDF) in order to identify facilitators and challenges to SHARE implementation. Domains facilitating SHARE implementation provided benefits in terms of 'knowledge', 'skills development', and supported the mentoring and role modelling provided by the hospice. Challenges highlighted the resource constraints of the long-term care context. The use of the TDF has enabled the identification of essential components such as skills development, which facilitate the implementation of SHARE in LTCF's.

Chameleon project: a children’s end-of-life care quality improvement project

“…There are several studies making a strong case for the significant impact that formal palliative care training can have on clinical staff care delivery when palliative care is integrated into their clinical patient care work 12–14 and a variety of educational approaches have been referred to in the literature, including on-site sessions and distance learning, 15 study half days, 16 simulation study days 17 18 and ongoing training programmes. 19 20 …”

Palliative care delivery in residential aged care: bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

“…The SHARE intervention was implemented over a year in 20 urban RAC facilities across two district health boards (DHBs) in one urban centre. This paper forms part of a larger mixed-method evaluation of SHARE which included quantitative assessments of staff palliative care delivery confidence, a records review of residents identified as benefitting from a palliative approach to care, as well as qualitative interviews with staff, general practitioners (GP's), facility managers and bereaved families [23].…”

Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

“…The SHARE intervention was implemented over a year in 20 urban RAC facilities across two district health boards (DHBs) in Auckland. This paper forms part of a larger mixed-method evaluation of SHARE which included quantitative assessments of staff palliative care delivery con dence, a records review of residents identi ed as bene tting from a palliative approach to care, as well as qualitative interviews with staff, general practitioners (GP's), facility managers and bereaved families (23).…”