Evaluation of a commissioned end-of-life care service in Australian aged care facilities

被引:3
|
作者
Mitchell, Geoffrey [1 ]
Melaku, Megdelawit [1 ]
Moss, Allison [2 ]
Chaille, Glenda [2 ]
Makoni, Blessing [2 ]
Lewis, Lannette [2 ]
Mutch, Allyson [1 ]
机构
[1] Univ Queensland, Fac Med, Herston Rd, Herston, Qld 4006, Australia
[2] CiMaS Home Nursing Serv, Newtown, Tas, Australia
关键词
End of life care service; Aged Care Facilities; Quality; Lack of expertise; Evaluation; Impact; Commissioning; PRIMARY-SECONDARY CARE; LONG-TERM-CARE; GENERAL-PRACTITIONERS; CASE CONFERENCES; PALLIATIVE CARE; NURSING-HOMES; MULTIDISCIPLINARY; PEOPLE; REDUCE;
D O I
10.1080/09699260.2021.1905146
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Residential aged care facilities (RACFs) face severe challenges in the provision of high-quality end of life care. A pilot of a nurse-led end-of-life palliative care consultative service (CiMaS) supporting RACFs was conducted in three RACFs in the West Moreton Region of Queensland, Australia, from May 2018. We conducted a mixed method evaluation comprising: a chart audit of deaths in the 12 months before and after the intervention; focus groups with RACF staff; and interviews with facility directors, primary family members and GPs. Quantitative and Qualitative data were assessed separately with statistical and thematic analyses respectively. The RACFs cared for 277 residents. There were 24 pre-intervention deaths and 44 in the intervention period (28 (64%) referred to CiMaS). There was widespread support for the service. Families felt supported and knowledgeable about what was happening. Care plans were almost always recorded in health records. Patients' symptoms appeared to be better recognised and managed. Staff and Facility managers felt more support than previously, with more responsive and reliable out of hours support. There were significant care improvements in patients not referred to CiMaS, suggesting a learning effect. GPs observed improvements in nursing staff confidence and support to families. Transfers to hospitals fell by two-thirds for both referred and non-referred patients compared with the year before implementation. The program was both efficient and effective.
引用
收藏
页码:229 / 237
页数:9
相关论文
共 50 条
  • [1] A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities
    Reymond, Liz
    Israel, Fiona J.
    Charles, Margaret A.
    AUSTRALIAN HEALTH REVIEW, 2011, 35 (03) : 350 - 356
  • [2] Acceptability and feasibility of end-of-life care pathways in Australian residential aged care facilities
    Horey, Dell E.
    Street, Annette F.
    Sands, Alison F.
    MEDICAL JOURNAL OF AUSTRALIA, 2012, 197 (02) : 106 - 109
  • [3] The role of advance care planning in end-of-life care for residents of aged care facilities
    Waird, Allyson
    Crisp, Elaine
    AUSTRALIAN JOURNAL OF ADVANCED NURSING, 2016, 33 (04) : 26 - 34
  • [4] COVID-19 pandemic: end-of-life experience in Australian residential aged care facilities
    Hack, Emma
    Hayes, Barbara
    Radcliffe, Nicholas
    Monda, Sally
    Yates, Paul
    INTERNAL MEDICINE JOURNAL, 2022, 52 (03) : 386 - 395
  • [5] Quality of life concerns and end-of-life care preferences of aged persons in long-term care facilities
    Chan, Helen Y. L.
    Pang, Samantha M. C.
    JOURNAL OF CLINICAL NURSING, 2007, 16 (11) : 2158 - 2166
  • [6] Quality end-of-life care in long-term care facilities: Service providers' perspective
    Brazil, K
    McAiney, C
    Caron-O'Brien, M
    Kelley, ML
    O'Krafka, P
    Sturdy-Smith, C
    JOURNAL OF PALLIATIVE CARE, 2004, 20 (02) : 85 - 92
  • [7] Understanding end-of-life care in Australian hospitals
    Mitchell, Imogen
    Lacey, Jeanette
    Anstey, Matthew
    Corbett, Cathy
    Douglas, Carol
    Drummond, Christine
    Hensley, Michel
    Mills, Amber
    Scott, Caroline
    Slee, Jo-Anne
    Weil, Jennifer
    Scholz, Brett
    Burke, Brandon
    D'Este, Catherine
    AUSTRALIAN HEALTH REVIEW, 2021, 45 (05) : 540 - 547
  • [8] End-of-Life Choices in Residential Aged Care
    Hudson, Rosalie
    AUSTRALASIAN JOURNAL ON AGEING, 2003, 22 (04) : 19 - 19
  • [9] Provision of palliative and end-of-life care in New Zealand residential aged care facilities: general practitioners' perspectives
    Balmer, Deborah
    Frey, Rosemary
    Gott, Merryn
    Robinson, Jackie
    Boyd, Michal
    AUSTRALIAN JOURNAL OF PRIMARY HEALTH, 2020, 26 (02) : 124 - 131
  • [10] Patient evaluation of end-of-life care
    de Vogel-Voogt, Elsbeth
    van der Heide, Agnes
    van Leeuwen, Anna F.
    Visser, Adriaan P.
    van der Rijt, Carin C. D.
    van der Maas, Paul J.
    PALLIATIVE MEDICINE, 2007, 21 (03) : 243 - 248