Nursing competencies across different levels of palliative care provision: A systematic integrative review with thematic synthesis

Abstract

<jats:sec><jats:title>Background:</jats:title><jats:p> Palliative care exists in diverse healthcare settings. Nurses play a crucial role in its provision. Different levels of palliative care provision and education have been recognized in the literature. Therefore, nurses need a set of various competencies to provide high-quality palliative care. </jats:p></jats:sec><jats:sec><jats:title>Aims:</jats:title><jats:p> To systematically synthesize the empirical evidence of (1) nursing competencies needed in palliative care and (2) whether these competencies differ across the level of palliative care. </jats:p></jats:sec><jats:sec><jats:title>Design:</jats:title><jats:p> Systematic integrative review with thematic synthesis. Prospero: CRD42018114869. </jats:p></jats:sec><jats:sec><jats:title>Data sources:</jats:title><jats:p> CINAHL, PubMed, Academic Search Premier, Scopus and Medic databases. Studies on nursing competencies linked to palliative care reported in English, Swedish, Finnish, Spanish, Portuguese or German were considered. Search terms: ‘palliative care or hospice care or end-of-life care’, ‘competency or professional competence or skills’ and ‘nursing’. Articles were independently screened and reviewed by two researchers. Quality appraisal was conducted following Hawker’s criteria. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> A total of 7454 articles were retrieved, 21 articles were included in the analysis. Six diverse nursing competencies dimensions, namely leadership, communication, collaboration, clinical, ethico-legal and psycho-social and spiritual were identified. The reports rarely defined the level of palliative care and covered a wide array of healthcare settings. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Nurses need a wide range of competencies to provide quality palliative care. Few studies focused on which competencies are relevant to a specific level of palliative care. Further research is needed to systematize the nursing competencies and define which nursing competencies are central for different levels of palliative care to enhance palliative care development, education and practice. </jats:p></jats:sec>

Nursing education on palliative care across Europe: Results and recommendations from the EAPC Taskforce on preparation for practice in palliative care nursing across the EU based on an online-survey and country reports

“…The alleviation of suffering is an essential function of nursing. 8,9,11,22 Nurses often act as a link between different professions, patient and family, and spend more time with patients at the end-of-life (i.e. the extended period of one to two years during which the patient/family and health professionals become aware of the life-limiting nature of their illness 23 ) than other healthcare disciplines.…”

“…8,[24][25][26][27] To be able to fulfil this role and provide individually tailored palliative care to patients with life-threatening/limiting illnesses and their families, nurses must be appropriately educated. 3,11,28,29 They should have the required competencies to be able to provide palliative care across settings and levels of specialization. 11 This has focused attention onto developing undergraduate and postgraduate programmes in palliative care nursing, although there seems to be global variations in the content of these programmes.…”

“…4,7–10 It requires the establishment of a dynamic caring relationship with the patient and family to reduce suffering, and also among nurses themselves and the multi-professional healthcare team. 11–21…”

Palliative Care: Ausbildungslandschaft Pflege

“…Um den Herausforderungen in der Palliative Care gerecht zu werden und den besonderen Bedürfnissen palliativ versorgter Menschen zu entsprechen, bedarf es bestimmter Fähigkeiten und Fertigkeiten von Pflegepersonen [3]. Diese geforderten Kompetenzen müssen den Standards von Palliative Care gerecht [5] und in der Ausbildung vermittelt werden [6].…”

“…Im § 22b des GuKG werden zudem die genauen Aufgabenbereiche von diplomierten Gesundheits-und Krankenpflegepersonen im Bereich Hospiz-und Palliativversorgung dargestellt [7]: (1) Die Hospiz-und Palliativversorgung umfasst die Pflege und Begleitung von Menschen mit einer fortschreitenden unheilba-ren und/oder lebensbedrohlichen Erkrankung und von sterbenden Menschen sowie von deren An-und Zugehörigen vor dem Hintergrund eines umfassenden biopsychosozialen Verständnisses von Krankheit unter Wahrung des Selbstbestimmungsrechts und Berücksichtigung des Patientenwillens mit dem Ziel, die Lebensqualität Um diesen Ansprüchen einer kompetenten Mitwirkung im Rahmen eines multiprofessionellen Palliativteams als Pflegeperson gerecht zu werden und die Qualität der Palliativversorgung zu sichern, müssen entsprechende Kompetenzen erworben werden [3]. Hökka und Kolleg*innen (2020) konnten sechs zentrale Kompetenzbereiche identifizieren, welche für Pflegende im Palliativen Setting relevant sind: Führung, Kommunikation, Zusammenarbeit, klinische, ethisch-rechtliche, psychosoziale und spirituelle Kompetenzen.…”