Emergency department staff priorities for improving palliative care provision for older people: A qualitative study.
Palliat Med
; 32(2): 417-425, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-28429643
ABSTRACT
BACKGROUND:
Emergency department-based palliative care services are increasing, but research to develop these services rarely includes input from emergency clinicians, jeopardizing the effectiveness of subsequent palliative care interventions.AIM:
To collaboratively identify with emergency clinicians' improvement priorities for emergency department-based palliative care for older people.DESIGN:
This was one component of an experience-based co-design project, conducted using semi-structured interviews and feedback sessions. SETTING/PARTICIPANTS:
In-depth interviews with 15 emergency clinicians (nurses and doctors) at a large teaching hospital emergency department in the United Kingdom exploring experiences of palliative care delivery for older people. A thematic analysis identified core challenges that were presented to 64 clinicians over five feedback sessions, validating interview findings, and identifying shared priorities for improving palliative care delivery.RESULTS:
Eight challenges emerged patient age; access to information; communication with patients, family members, and clinicians; understanding of palliative care; role uncertainty; complex systems and processes; time constraints; and limited training and education. Through feedback sessions, clinicians selected four challenges as improvement priorities time constraints; communication and information; systems and processes; and understanding of palliative care. As resulting improvement plans evolved, "training and education" replaced "time constraints" as a priority.CONCLUSION:
Clinician priorities for improving emergency department-based palliative care were identified through collaborative, iterative processes. Though generally aware of older palliative patients' needs, clinicians struggled to provide high-quality care due to a range of complex factors. Further research should identify whether priorities are shared across other emergency departments, and develop, implement, and evaluate strategies developed by clinicians.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
/
Serviço Hospitalar de Emergência
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Enfermagem Geriátrica
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Corpo Clínico Hospitalar
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
Limite:
Adult
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Palliat Med
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Reino Unido