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Sharing Current Scottish Practice

Poster Abstracts of the Month: February

The SPPC Annual Conference in 2019 featured 32 poster displays, sharing work and research underway across Scotland. Each month, this blog focuses on the content of a few of these posters. This month, we focus on:

How can we ensure a realistic approach to dietetic care in acute medical inpatients? A retrospective cohort study of survival-related outcomes in patients referred to dietetics in NHS Fife

Author(s)

Jamie Kok, Angela Southam, Scot Bullivant, Huai Ling Tan, Joanna Bowden

Introduction: In NHS Fife, acute hospital admissions who are identified as being at risk of malnutrition are referred to dietetics. Our objective was to characterise the acute medical population referred to dietetics over a one month period and to examine their survival-related outcomes.

Methodology: A retrospective cohort study of 206 referrals to the dietetics department of Victoria Hospital, Kirkcaldy in September 2017 was undertaken. Descriptive statistics were produced to characterise the population and their outcomes. Binomial logistic regression and Kaplan Meier survival analyses were also used.

Results: 36% of patients referred to dietetics had died within 3 months of referral. By 18 months, only 40% of patients were still alive. Older age and low albumin levels were associated with shorter survival (p<0.0001). People with cancer had lower one year survival rates than those without cancer.

Conclusion: A significant proportion of acute medical patients referred to dietetics are in their last phase of life. If patients with a poor prognosis are not identified, they are at risk of receiving dietetic interventions that do not add value. Conversely, patients with a good prognosis can also benefit from being identified. This should enable dietitians to tailor their interventions individually, so as to provide the best care possible.

Introducing the Macmillan Support Worker : Innovative Practice within a Community Palliative Care Service

Author(s)

Jan Dobie, Jade Cantwell, Leslie Chapman, Sheila Shaw

The Community Palliative Care Team (CPCT) in East Lothian comprises 3 full time Clinical Nurse Specialists (CNS).

As an organisation, Macmillan has recognised that care coordination is not one person’s role, job or responsibility. It is the joining up of services, coordination, information and communication between care givers, treatment providers and those living with life limiting conditions and their families. To that effect, Macmillan has developed a model and potential workforce solution; a Band 4 Role called a Macmillan Support Worker (MSW).

In discussions with Senior Management within East Lothian Health and Social Care Partnership and Macmillan, the CPCT recognised that a MSW would be of benefit in helping patients to achieve positive outcomes and would also support the team by sharing and coordinating care in a more efficient way. This was a new initiative which had never been tried in Scotland.

Funding was secured from Macmillan Cancer Support for a 2 year pilot project to introduce a Band 4 Support Worker.

This poster will share experiences and data from September 2018 to the current date.

Examples will be provided of what the MSW has been able to achieve and how this has influenced practice and patient and family care.

‘Making Memories’ – An Exhibition of artwork by patients of Victoria Hospice

Author(s)

Amy McNeil

Stigma surrounding hospice care can become a barrier to accessing specialist services. Often misconceptions mean patients who would benefit most from Day Hospice are reluctant to consider attending. Whilst society accepts the need for palliative care, alternative approaches can be made to highlight the Specialist Palliative Care service and engage local communities, helping to change perceptions of the service and patients.

Art sessions are an integral part of Hospice Day Care, providing significant benefits to patients’ health and wellbeing, resulting in a variety of meaningful artwork. Over 3 months in 2018, day patients’ artwork was exhibited in a public art gallery with the intention of engaging the public through art instead of information.

As the exhibition was unmanned the number of visitors and the effect of the exhibition will remain unknown. The majority of feedback came from those already aware of services offered, in particular friends and family of deceased patients, all of who commented on the significance of a having local, non-clinical venue in which to reflect. The exhibition as a whole provided them comfort and a connection to their loved ones.

Overall the exhibition showed the potential for using art to create connections and conversations surrounding specialist palliative.

Music to my ears: Implementing personalised music playlists in a Hospice Inpatient Unit (IPU)

Author(s)

Kim Donaldson, Jen McLean, Liz Collins, Fiona Cruickshank, Erna Haraldsdottir

Background:

Creating individualised playlists for people living with a dementia has positive benefits including the reduction of behavioural and psychological symptoms1. As hospices across the UK have been urged to build skills needed to support people with dementia2 we decided to implement Playlist for Life3 within our IPU as a creative way of offering support to patients and their families. Although our initial aim was to work with people with a dementia, we have also used Playlist for Life3 for people with other cognitive impairments or none at all.

Using Playlist for Life3 has:

Enabled life story telling and reminiscing

Supported the management of breathlessness and anxiety

Increased sense of wellbeing

Supported Advanced Care Planning

Been a legacy for family members.

Our next steps are to:

Continue to establish an evidence base in a hospice setting through further evaluation

Establish referral criteria.

Outcome:

Individualised music playlists can be an effective therapeutic tool in a hospice setting.

1Bowell, S. and Bamford, S.M. 2018. What would life be – without a song or a dance, what are we? ILC –UK: London.

2Hospice UK. 2015. Hospice enabled dementia care: The first steps. Hospice UK: London.

3Playlist for Life. 2019. https://www.playlistforlife.org.uk/


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