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36 Together to care

Introduction Although many care homes are committed to providing good quality end of life care, in reality a significant number of Nursing Home (NH) residents die in hospital after emergency admission hours or days before their death. To provide more coordinated services for dying people and their families, the hospice in partnership with a NH developed a six month project with the NH providing 2 palliative care beds and in return for a comprehensive training package in end of life care. Research aim Assess the impact of the educational intervention on NH staff and therefore their confidence and competence in caring for residents at the end of life. Methods A longitudinal mixed method approach using 3 methods at baseline, 3 and 6 months: 1. A survey to all NH staff incorporating a self-efficacy palliative care scale (SEPC) to rate confidence on a 10 point Likert scale (Mason and Ellershaw, 2004). 2. Pre and post intervention semi-structured interviews with the staff participating in the T2C educational intervention. 3. Focus group of hospice staff 6 months post T2C educational intervention. Results At 6 months confidence increased and was sustained in all aspects of end of life care but most markedly in communication and symptom control. Confidence decreased in NH staff not undertaking the education intervention indicating work to do in peer learning. Conclusion A palliative care educational intervention can increase confidence and competence in NH staff to care for residents in a NH so reduce risk of unplanned hospital admission. Reference . Mason, S. Ellershaw, J. Assessing undergraduate palliative care education: validity and reliability of two scales examining perceived efficacy and outcome expectancies in palliative care. Medical Education2004;38:1103–1110