High quality, coordinated palliative and end-of-life services in the community allow people to die at home supported by family, friends and services. Homecare nurses and personal care workers are perfectly placed to achieve this; however, must be appropriately trained and supported by capacity built within generalist organisations.
This project aimed to incorporate a general palliative approach as part of standard practice for individuals supported by an aged and community care provider, recognising and planning for an end-of-life that is evidence-based, person-centred, holistic and promotes quality of life.
Several interlinking activities covering stakeholder engagement, education, and evaluation were undertaken in the outer eastern region of Melbourne. The approach was designed to re-build capacity and processes within the organisation, championed by the Nurse Practitioner – Palliative Care. A mixed-method evaluation elucidated the experience of Nursing Care Managers through focus groups, including barriers and enablers to providing a general palliative approach in the community; with data from electronic care records used to identify the impact of the project on key palliative care indicators.
The trusted relationships established between nurses and clients were seen as invaluable in supporting individual palliative care needs. The education program increased staff knowledge and confidence in providing a general palliative approach, particularly in Advance Care Planning. There was also a greater awareness and willingness to refer to other professionals to support both staff and clients, with improved documentation in client care records.
Highly skilled and experienced palliative care nurses within generalist organisations are integral to drive continual improvement, support system development and facilitate dissemination of best-practice knowledge and care.
Utilising and strengthening collaborative working partnerships between generalist and specialist services to provide quality community-based palliative care benefits both parties, and importantly, clients and carers.
We confirmed the significant role that generalist nursing services play when a palliative approach to care is incorporated. Investment in developing the capacity and capability of generalist services to deliver palliative care is vital, underpinned by expert palliative care nurses.
This project was funded by Eastern Melbourne Primary Health Network, as part of the Commonwealth’s Core Flexible and After-Hours funding.