Developing, implementing and evaluating an end of life care intervention
Evidence & Practice    

Developing, implementing and evaluating an end of life care intervention

Anna Cox Research fellow, University of Surrey
Anne Arber Senior lecturer (cancer and palliative care), University of Surrey, Guildford, Surrey
Fiona Bailey Consultant in palliative medicine, Woking and Sam Beare Hospices, Woking, Surrey
Sue Dargan Senior specialist nurse in palliative care, Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey
Craig Gannon Consultant/medical director, Princess Alice Hospice, Esher, Surrey
Radcliffe Lisk Consultant orthogeriatrician, Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey
Barry Quinn Clinical lead for end of life care, Chelsea and Westminster Hospital NHS Foundation Trust, Greater London
Jane Samarasinghe Clinical nurse specialist, palliative care, Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey
Martha Wrigley Research and development manager, Ashford and St Peter's Hospitals NHS Foundation Trust, Surrey
Ann Gallagher Professor of ethics and care, University of Surrey, Guildford, Surrey

Aim To develop, implement and evaluate a collaborative intervention in care homes seeking to increase the confidence and competence of staff in end of life care and enable more people to receive end of life care in their usual place of residence.

Method A two-phase exploratory mixed methods design was used, evaluating the effect of an end of life care toolkit and associated training in care homes, facilitated by a specialist palliative care team. Six care homes in England were recruited to the intervention; 24 staff participated in discussion groups; 54 staff attended at least one training session; and pre- and post-intervention questionnaires were completed by 78 and 103 staff respectively.

Results Staff confidence in receiving emotional and clinical support and managing end of life care symptoms increased post-intervention, but confidence in discussing death and dying with residents and relatives decreased. Audit data indicate greater reduction in the number of residents from participating care homes dying in hospital than those from comparison homes.

Conclusion Collaborative end of life care interventions support care home staff to manage end of life and may enable residents to have choice about their place of death.

Nursing Older People. doi: 10.7748/nop.2017.e873

Correspondence

a.cox@surrey.ac.uk

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Received: 28 September 2016

Accepted: 01 December 2016

Published online: 11 January 2017