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Biannual research newsletter – Autumn/Winter 2016

Our Biannual research newsletter details the research activity as well as information on the wider research community.

Association of Palliative Medicine conference 2016

UTI antibiotic stewardship in a UK Hospice: two audit cycles spanning two years and more than 500 patients

An audit to identify the incidence of a urinary tract infection in the last 30 days of life and review the investigations, treatment  and outcomes and measure this against the standards for management of patients with a Urinary tract infection.

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What level of medical input do hospice inpatients need?

An evaluation of medical need on an in-patient unit where patients are split into ‘general palliative care’ and ‘specialist palliative care’ to address the nursing skill mix and increase bed occupancy.

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Hospice UK Conference November 2016

A proposal for hospices to work together on information and knowledge support

An initiative to share information and knowledge throughout the UK would see hospices share journal articles, current awareness services, acquisition lists, online information skills training and journal club support.

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An innovative model of care enabling a hospice IPU to reach more people

Implementing a new model of working, piloting two distinct wards with a different nursing structure and skill mix with the aim of reaching more patients through an increased capacity to care for more patients.

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Anxiety management in practice: A multi-disciplinary approach to support hospice patients to manage their anxiety

The development of a relaxation CD, to extend the efficacy of relaxation sessions and encourage and enable each person to support themselves.

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Continued, successful use of ultrasound in a hospice

The results of regular audits to monitor the use of ultrasound in palliative care setting and whether scans adhered to course standard.

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Developing a resilient workforce

Working in palliative care can be associated with the stress of caring for people who are ill. This poster demonstrates the organisational developments in raising awareness of resilience and staff wellbeing and initiatives available to support staff.

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Evaluation of aroma sticks for anxiety as an extension of aromatherapy treatment

An evaluation to explore the impact of aroma stick use on hospice patients’ anxiety.

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Seventeen and super keen. Young people volunteering on an In-Patient Unit

An innovative new volunteering programme aimed at 17-year-olds interested in a career in healthcare.

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European Association of Palliative Care 2016

Developing a research strategy 

Reed, E Todd, J Developing a research strategy in a hospice in England. European Journal of Palliative Care, 2016; 23(2)

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Analysis of hospice to hospital transfers

Using an evidence base on utilization of hospital resources for patients at the end of life and explore decision making processes and outcomes for patients transferred to hospital from hospice.

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A multi-professional educational intervention to improve and sustain participants’ confidence to deliver palliative care: a mixed-methods study.

A study to evaluate the impact of the European Certificate  in Essential Palliative Care on candidates’ confidence in palliative care and determine if this is sustained over time.

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Hospice UK Conference November 2015

The experience of family caregivers living with patients with the symptoms of advanced cancer

This phenomenological study used purpose sampling to determine the experiences of family caregivers. The results allow the hospice to further understand how we can offer the necessary support to caregivers.

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Living with Xerostomia (dry mouth)

Our study presents the experience of adults with Xerostomia within a community/day hospice care setting and puts forward coping strategies to help, guide and improve practise.

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Enhancing a sense of community

Exploring the development and benefits of our hospice based Community Choir.

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National UK food and nutrition hospice survey

A study aimed at identifying issues relating to food and nutrition in hospices in the UK.

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Open Art Studio

A look at the implications of introducing an open art studio into a hospice environment.

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Journal articles/research

Gillett, K. Reed, L. Bryan, L. Using action learning sets to support change in end-of-life care. Leadership in Health Services. Volume 30, issue 2

This paper describes the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course and the challenges, learning, and benefits of using action learning sets to improve end-of-life care. Hospices and other health care organisations work in partnership to deliver this programme and this paper demonstrates how action learning sets can increase mutual understanding and communication between specialist and non-specialist end-of-life care settings.

Shine, M.  Advanced Care Planning: the HCA’s role. British Journal of Healthcare Assistants. August 2016 Vol 10 No 08

Healthcare Assistants are often providing the day to day care of patients and can pay a key role in supporting patients at the end of life. In this paper, Martin Shine an HCA at Princess Alice Hospice discusses the important role of the HCA in advance care planning and the importance of providing adequate education and support to HCA’s so they have the confidence and communication skills to facilitate these discussions.

Reed, E. Todd, J. Developing a research strategy in a hospice in England. European Journal of Palliative Care, 2016; 23(2)

In 2013, Princess Alice Hospice recruited a research lead to develop research across the organisation. A research strategy was developed using a collaborative approach in order to encourage hospice staff from as many different disciplines as possible to engage with research. This paper describes the process of developing a research strategy and promoting engagement with research internally and the hospice to be a research active organisation.

Spencer, L. Hospice to home: a patient-centric multi professional community approach. International Journal of Palliative Nursing. 2015 May;21(5):245-50.

As people live longer with multidimensional health and end-of-life care needs, palliative care provision is becoming increasingly complex. Demands on hospice services are increasing, therefore new models of care are needed that are accessible to a wider range of patients. Most people prefer to die at home (Gomes et al, 2013a); however, evidence reports that the most common place of death is hospital (53%) (Marie Curie, 2013). This article describes how one hospice developed a model of care working in partnership with statutory services that provided patient-centred care, achieved preferences and prevented unnecessary admissions into hospital. It describes each element of the model and how they work seamlessly together. The evaluation of the model suggests that maximal impact can be gained by focusing service development on expanding and improving care at home. Preventing unnecessary hospital admissions, while simultaneously improving the quality of care, remains the fundamental driver for high-quality end-of-life care.

 

Taylor, H.N Bryan, K. Palliative cancer patients in the acute hospital setting – Physiotherapists attitudes and beliefs towards this patient group. Progress in Palliative Care. Volume 22, Issue 6 (December, 2014), pp. 334-341

 

With advances in medical technology, increasing numbers of patients are ‘living with’ a terminal cancer diagnosis for longer periods; this coupled with changes in government policy is resulting in patients being treated closer to home rather than in specialist centres, bringing acute hospital physiotherapists into increasing contact with this patient group. This study aimed to describe the experience of acute hospital physiotherapists with palliative cancer patients. The study identified, attitudes and issues, with four sub-themes in attitudes (terminology, physiotherapists perceptions, other professionals perceived attitudes towards physiotherapists, and patients and families perceived attitudes towards physiotherapists’); there were six sub-themes in issues (communication, education, emotions, boundaries, referring onward from the acute setting, and time).

 

Some physiotherapists understand and apply their skills to improve the quality of life of palliative cancer patients. However, it is suggested that the majority of physiotherapists regard these patients as ‘dying from’ rather than ‘living with’ a terminal cancer diagnosis. Referral protocols and service pathways are lacking. There is an opportunity to improve how the profession promotes itself to other professionals, the public and physiotherapists of the future, to facilitate palliative cancer patients’ access to rehabilitation when and where they need it, and to deliver services in line with government policy.

 

Reed E, Cullen A, Gannon C, Knight A, Todd J. Use of Schwartz Centre Rounds in a UK hospice: findings from a longitudinal evaluation. J Interprof Care. 2014 Nov 25:1-2

Schwartz Centre Rounds® aim to explore the human and emotional impact of everyday work by giving healthcare staff the opportunity to come together in a safe but open environment. We evaluated the experience of introducing Schwartz Centre Rounds in Princess Alice Hospice over one year using a mixed method approach. Available via PubMed.

Reed, E. Todd, J. Lawton, S. Grant, R, Sadler, C. Berg, J. Lucas, C. Watson, M. A multi-professional educational intervention to improve and sustain respondents’ confidence to deliver palliative care: a mixed-methods study. Palliative Medicine in press.

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