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Sharing Current Scottish Practice

Poster abstracts of the month: August

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:

NHS Forth Valley Macmillan Healthcare Support Worker Project

Author(s) Jane Niblo, Sandra Campbell
Macmillan project supporting community teams to provide person centred palliative and end of life care to patients in their own homes, and to support those close to them. To inform and develop a new model of palliative and end of life care to enable patients to die in their own homes if that is their wish to do so. To reduce inappropriate admissions to hospital at end of life and reduce the number of hospital bed days during last six months.

Oral care at end of life

Author(s) Morag Muir, Leigh Deas, Maura Edwards
Caring for Smiles is a national oral health improvement programme which provides training for staff in care homes to support them in delivering daily oral care for residents. Good oral health is a basic human right and maintaining a clean and comfortable mouth is essential during the end stages of life. The Caring for Smiles Guide for Care Homes includes advice for providing oral care to individuals receiving palliative or end of life care who are no longer able to maintain their own oral health. Hands on training for staff is also available and is delivered by Caring for Smiles teams from local health boards across Scotland. This poster aims to raise the profile of the Caring for Smiles programme and to emphasise the importance of oral care for individuals receiving end of life care. This issue is becoming increasingly important as care homes take on more responsibility for end of life care.

Paediatric End of Life Care - A National Managed Clinical Network Approach to Improving Care

Author(s) Dr Natalie Smee National Services Scotland, Dr Morag Campbell NHS Greater Glasgow and Clyde, Dr Mike Winter National Services Scotland
The Scottish Government is committed to support the development and provision of specialist paediatric palliative care services. Integral within, but not exclusive to, is the provision of end-of-life care to the 2,200 patients per year who become unstable and deteriorate towards the end of their natural lives (200 will die), and to the additional annual 200 deaths out-with paediatric palliative care. The provision of end-of-life care is of inviolable importance as experiences shape the child’s legacy and the family’s grief, yet accessibility family choices and service delivery are not equitable. Without a transparent nationally adopted strategy drawn by the shared vision of all committed multi-disciplinary stakeholders, a cacophony of diverse inconsistent practices will prevail. National Services Scotland has launched 'PELiCaN' - the paediatric end-of-life care network - commissioned to improve the national provision of 'family-integrated, personalised, realistic care' to all families whose child is approaching the end of their natural life, regardless of age, ethnicity or geographical location.
Although embryonic, the intention is to facilitate regional roadshows to understand contemporary practices (excellence and deficits) and opinions, followed by a national launch event. The overarching multi-disciplinary steering group will collaborate with existing networks and organisations, and establish informative work-streams (data analysis; structural; operational; educational; miscellaneous - national ethics committee, organ donation). The aim is to ensure equality and improve the burdensome experience of all families facing such a devastating loss by offering deliverable choices that meet the autonomous individualised wishes of the families.

Palliative Care: Succession planning for rare beasties

Author(s) Jenny Doig Developing potential palliative care educators
Palliative care educators are `rare beasties` who either work as part of a generalist team or a small hospice education team. A large part of the palliative care educator`s role involves collaborating and networking with hospices, universities and specialist colleagues. Thus, opportunities for clinical staff to experience this role, prior to appointment, are limited. In August 2018 NHS Lothian Clinical Education and Training staff were offered a development opportunity in palliative and end of life care education.
Aim: To enable staff to gain an in-depth perspective of palliative and end of life care education by shadowing the Macmillan Cancer and Palliative Care Educator, half a day a week for a 3-month period. 7 staff applied and were selected to shadow. Each participant set their own palliative and end of life care learning objectives. Participants met regularly to discuss their objectives with the post incumbent, conducted a literature search, were introduced to palliative care networks, met with relevant clinical staff, and presented a reflective account of their learning The qualitative results of the first three placements will be presented.

Palliative care volunteers in Europe: qualitative analysis of volunteer activities and experiences

Author(s) Ros Scott, Anne Goossensen, Sheila Payne, Leena Pelttari
It is often others, rather than volunteers, who describe their activities and experiences. Led by the EAPC Task Force in Volunteering, this project aimed to enable volunteers to tell, in their own words, their personal experiences and what it means to them to volunteer in HPC.
The aims were to understand: 
  • the experiences of volunteers in HPC 
  • why they work in HPC 
  • what HPC volunteering means to them
Task Force members in seven countries were asked to invite five volunteers to write about their volunteering activities and experiences in their own language. Two prompt questions were given to volunteers: “What do you do as a volunteer?” “What does it mean to you?” Stories were translated into English and a qualitative framework used for analysis.
Results: 
  • In total, 37 stories of 400-500 words were received from eight countries. 
  • Almost all (n=34) volunteers offered practical, emotional, social and spiritual support to adult patients and families. 
  • 32 were involved in diverse adult HPC settings including patient’s homes, hospices, hospitals and care homes and two in community children’s palliative care 
  • All found significant meaning in HPC volunteering, described as an important part of their life and values. 
  • Volunteers described the privilege of being with people at end of life and how much they learn from encounters with death and dying. 
  • Others describe the challenges of HPC volunteering and how their lives are enhanced by their experience.
Conclusion: The narratives gave an insight into personal stories of volunteers in different countries and highlighted many similarities in shared experiences and values. Understanding these perspectives can help HPC organisations to improve how volunteer skills may best be utilised and supported.

Palliative News: Back to the Future

Author(s) Katy Paterson, Jacquie Smith
“Learn from yesterday, live for today, hope for tomorrow” ~ Albert Einstein
The poster will be an illustrative presentation of a six month evaluation of the lived experience of 15 patients who attended Edwina Bradley Day Hospice with a focus of improving symptom burden and functional status. Included will be qualitative and quantitative data presenting the efficacy of patient engagement and participation, the creative approach of a multidisciplinary team and the supportive model nurturing participans to reflect on the past in order to move forward.

Project ECHO: Supporting children transitioning to adult palliative care services

Author(s) Jayne Grant, Danielle Harley
Project ECHO (Extension for Community Healthcare Outcomes) is a FREE collaborative model of clinical education and care management that empowers professionals everywhere, CHAS as a Project ECHO Hub are using its methodology to provide enhanced care to more children in their community. CHAS believes that the ECHO methodology could work well to provide Adult Hospices with an unparalleled forum to network, receive peer support and to share knowledge and best practice around the care of young adults transitioning from children’s hospices. The number of babies, children and young people in Scotland with palliative care needs in 2016/17 was 15,949 aged between 0 – 21. Of these 4,609 were in the 12 – 18 age bracket and 2,108 in the 19 – 21 age bracket. (CHiSP2 2018). There are already over 185 participants registered with CHAS Project ECHO, from varying communities of practice sharing knowledge and skills, making better links with professionals ensuring continuity of care.
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