Sharing Current Scottish Practice

Author(s) of poster: Susan Campbell, Fiona Cruikshank, Miriam Tadjali, Stephen Tinney, Kirsty Cornwall

‘Making today matter’ is our everyday business. We not only look after people’s physical needs, but also their needs as individuals and important members of their own families/social networks. Patients wish to mark a special occasion – bringing Christmas forward or supporting a couple to get married - during their time with us, and it is our aim to support them wherever we can. Special events and celebrations are held to create memories for the future. We also look at the nutritional aspect of all catering which is provided to patients and where they are assessed to be requiring additional nutritional support this is undertaken by the hospice team. A nutritional chart/ tool has been developed to identify which patients could be at risk. The care we provide goes above and beyond treating physical symptoms. It is difficult to measure the impact of the ‘extra’ effort that staff put into looking after people’s needs in any tangible way, but the gratitude people feel is clear to see; ‘Thank you….…for our beautiful wedding – balloons, food, service, flowers, location, driver who took me to get wedding rings, cake, bubbly. You made our day so very special.’

Managing not mending

Author(s) of poster: Jan Stanier Lead Speech & Language Therapist, Clyde Acute NHS Greater Glasgow & Clyde/Queen Margaret University Edinburgh; Dr Janet Beck, Head of Speech & Hearing Sciences, Queen Margaret University Edinburgh and Dr Mairghread Ellis, Programme Lead Podiatry, Queen Margaret, University Edinburgh

This poster depicts the preliminary findings of an exploration into the experiences of Speech and Language Therapists in providing end of life dysphagia (swallowing) care to people with Head and Neck Cancer. Whilst previous researchers have explored what the role entails (Pollens 2012; 2004, Newman 2009, Roe 2007), to date the reported experiences of those providing this care has not been fully examined. The study adopts a qualitative, phenomenological approach and has a multi-centre design.

The research question asks ‘What is the experience of Speech & Language Therapist in providing end of life care to people with head and neck cancer’.

Preliminary findings indicate that SLTs described a lack of preparation and guidance, differing experiences across settings, successes and challenges with multi-disciplinary team working, a view that swallowing management is different with this caseload, some lack of awareness and clarity around the SLT role, a considerable emotional impact and a concern with effective risk management and patient led decision making.

Palliative care training for social work home carers in Renfrewshire

Author(s) of poster: Susan Jackson

There is increasing recognition that the population in Scotland like other areas in the UK is ageing. Many people are living with the effects of one or more chronic illnesses (Audit Scotland 2008) with much of their care being delivered in the home or care home setting. Palliative care is a core component of the care package for this population and as such should be routine practice for health care professionals. However social care home carers are now facing clients with palliative care needs on a daily basis and are often unprepared for the situations they encounter. To address this within Renfrewshire, Accord Hospice designed and delivered several education sessions specifically tailored for this group and found it to be a worthwhile exercise with participants expressing increased confidence in their knowledge of palliative care. As a result discussions took place with Renfrewshire Community Health Partnership (CHP) and Renfrewshire Council to consider a collaborative approach to delivering a palliative care education and training programme for the home care service. An application was made to the Queen's Nursing Institute Scotland (QNIS) for a Partnership in Practice award which supported the delivery of a series of training days to 200 social home care staff in a period of 12 months.

Panning for gold: Ensuring an evidence base for End-of-Life decision making

Author(s) of poster: Margaret Colquhoun and Joyce Templeton

The End-of-Life Care (EOLC) Group is part of Clinical Governance at the Hospice with responsibility for quality EOLC. Good outcomes depend on staff having timely access to evidence for decision-making and understanding individual patient/family choices(1). Information literacy – i.e. access to electronic databases and search skills – are central to achieving this(2) in the context of an expanding literature. Membership of the EOLC Group is varied in terms of discipline and academic background. Using the metaphor of panning for gold, the Librarian and the Senior Nurse Lecturer, supported members to access the NHS Knowledge Network and set up electronic database search alerts. Members - individually or in pairs - selected an aspect of EOLC e.g. documentation or care after death, set up an alert and they bring relevant articles – ‘nuggets’ - to the meeting. Although not without its challenges, this approach has promoted staff engagement and integration of evidence with practice.

References:

1.Rutledge, D.N., Kuebler, K.K. 2005. Applying evidence to palliative care. Seminars in Oncology Nursing, 21 (1) pp.36-43.

2.Callinan, J. et al 2010. Analysis of library-associated information needs of staff in a specialist palliative and gerontological care centre in Mid-West Ireland. Health Information and Libraries Journal, 27, pp.286-294.

Partnership working to improve the quality of end of life care in care homes and at home

Author(s) of poster: Jan Dobie (Lead facilitator) Marlis Plumb (Facilitator) Sarah Shepherd (Facilitator) Louise Wood (Administrator)

Poster describes a 2-year fixed-term project which aims to improve the quality of end of life care for residents in care homes and for people dying at home. A pre education review of deceased residents’ records is carried out to establish baseline practice, highlight good practice and inform development of educational content. ‘End of Life’ study days are then delivered to care home staff. 8 comparable study days have been delivered as a pilot for home care staff. Resource packs and literature are supplied to each care home/ home care participant. Study days have been highly evaluated by participants. To date, over 600 staff have attended. There is also a reflective evaluation after 3 months. This unique project has allowed interprofessional collaboration and communication between professional groups and organizations: managers, educators, clinicians, pharmacy, specialist palliative care, Care Inspectorate, Scottish Care, local authorities and key stakeholders.

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