Using Palliative Care Needs Rounds in the UK for care home staff and residents: an implementation science study

作者：Liz Forbat, Aisha Macgregor, Karen Spilsbury, Brendan McCormack, Alasdair Rutherford, Barbara Hanratty, Jo Hockley, Lisa Davison, Margaret Ogden, Irene Soulsby, Maisie McKenzie · 发表于：Health and Social Care Delivery Research · 年份：2024 · DOI：10.3310/krwq5829 · 被引用次数：3 · 研究领域：Palliative Care and End-of-Life Issues、Geriatric Care and Nursing Homes、Frailty in Older Adults

Background Care home residents often lack access to end-of-life care from specialist palliative care providers. Palliative Care Needs Rounds, developed and tested in Australia, is a novel approach to addressing this. Objective To co-design and implement a scalable UK model of Needs Rounds. Design A pragmatic implementation study using the integrated Promoting Action on Research Implementation in Health Services framework. Setting Implementation was conducted in six case study sites (England, n = 4, and Scotland, n = 2) encompassing specialist palliative care service working with three to six care homes each. Participants Phase 1: interviews ( n = 28 care home staff, specialist palliative care staff, relatives, primary care, acute care and allied health practitioners) and four workshops ( n = 43 care home staff, clinicians and managers from specialist palliative care teams and patient and public involvement and engagement representatives). Phase 2: interviews ( n = 58 care home and specialist palliative care staff); family questionnaire ( n = 13 relatives); staff questionnaire ( n = 171 care home staff); quality of death/dying questionnaire ( n = 81); patient and public involvement and engagement evaluation interviews ( n = 11); fidelity assessment ( n = 14 Needs Rounds recordings). Interventions (1) Monthly hour-long discussions of residents’ physical, psychosocial and spiritual needs, alongside case-based learning, (2) clinical work and (3) relative/multidisciplinary team me...