What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand

2015 ◽  
Vol 24 (4) ◽  
pp. 450-462 ◽  
Author(s):  
Rosemary Frey ◽  
Michal Boyd ◽  
Sue Foster ◽  
Jackie Robinson ◽  
Merryn Gott
Keyword(s):  
Palliative Care ◽  
New Zealand ◽  
Care Delivery ◽  
Aged Care ◽  
Organisational Culture ◽  
Residential Aged Care

scholarly journals Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

2020 ◽  
Author(s):  
Rosemary Ann Frey ◽  
Sophia Barham ◽  
Deborah Balmer ◽  
Jackie Robinson ◽  
Michal Boyd ◽  
...  
Keyword(s):  
Palliative Care ◽  
Systems Of Care ◽  
Care Delivery ◽  
Aged Care ◽  
Residential Aged Care ◽  
Structured Interviews ◽  
Palliative Care Education ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Bereaved Family

Abstract Background : The supportive hospice aged residential exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' knowledge and skill to care for frail older people. Method : The experiences of 18 bereaved families concerning the palliative care journey (both at the start and finish of a one-year implementation of SHARE) were explored using semi-structured interviews. Results: Three themes were important to bereaved families’ experience: communication with staff, systems of care, and hospice involvement. Sub-themes indicating changes in these three components of care between the start and finish of SHARE was identified. A fourth theme highlighted challenges (relationship with GP, staff shortages and turnover) that continued across SHARE. Conclusion : Findings indicated that SHARE benefited families (improved communication and support) through the end of life journey of their relatives, but challenges remained.

scholarly journals Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

2020 ◽  
Author(s):  
Rosemary Ann Frey ◽  
Sophia Barham ◽  
Deborah Balmer ◽  
Jackie Robinson ◽  
Michal Boyd ◽  
...  
Keyword(s):  
Palliative Care ◽  
Systems Of Care ◽  
Care Delivery ◽  
Aged Care ◽  
Residential Aged Care ◽  
Palliative Care Education ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
One Year ◽  
Bereaved Family

Abstract BackgroundThe supportive hospice aged residential Exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' knowledge and skill to care for frail older people.MethodThe experiences of 16 bereaved families concerning the palliative care journey (both at the start and finish of a one-year implementation of SHARE) were explored using semi-structured interviews.ResultsFour themes were important to bereaved families’ experience: communication with staff, relationship with general practitioners, systems of care, and hospice involvement. A sub-theme indicating changes in these four components of care between the start and finish of SHARE was identified. A fifth theme highlighted challenges (staff shortages and turnover).ConclusionFindings indicated that SHARE benefited families (improved communication and support) through the end of life journey of their relatives, but challenges remained.

scholarly journals Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention

2020 ◽  
Author(s):  
Rosemary Ann Frey ◽  
Sophia Barham ◽  
Deborah Balmer ◽  
Michal Boyd ◽  
Jackie Robinson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Systems Of Care ◽  
Care Delivery ◽  
Aged Care ◽  
Residential Aged Care ◽  
Structured Interviews ◽  
Palliative Care Education ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Bereaved Family

Abstract Background: The supportive hospice aged residential exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' knowledge and skill to care for frail older people. Method: The experiences of 18 bereaved families concerning the palliative care journey (both at the start and finish of a one-year implementation of SHARE) were explored using semi-structured interviews.Results: Three themes were important to bereaved families’ experience: communication with staff, systems of care, and hospice involvement. Sub-themes indicating changes in these three components of care between the start and finish of SHARE was identified. A fourth theme highlighted challenges (relationship with GP, staff shortages, and turnover) that continued across SHARE.Conclusion: Findings indicated that SHARE benefited families (improved communication and support) through the end of life journey of their relatives, but challenges remained.

Enhancing palliative care in rural Australia: the residential aged care setting

2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti
Keyword(s):  
Palliative Care ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Advance Care

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

scholarly journals Medication omission rates in New Zealand Residential Aged Care Homes: a national description

2020 ◽  
Author(s):  
Stephanie M Garratt ◽  
Ngaire M Kerse ◽  
Kathryn Peri ◽  
Monique F Jonas
Keyword(s):  
New Zealand ◽  
Clinical Decision Making ◽  
Home Ownership ◽  
Medication Administration ◽  
Aged Care ◽  
Care Staff ◽  
Residential Aged Care ◽  
Level Of Care ◽  
Ownership Type ◽  
Level Data

Abstract Background A medication omission is an event where a prescribed medication is not taken before the next scheduled dose. Medication omissions are typically classed as errors within Residential Aged Care (RAC) homes, as they have the potential to lead to harm if poorly managed, but may also stem from good clinical decision-making. This study aimed to quantify the incidence, prevalence, and types of medication omissions in RAC homes on a national scale, using a New Zealand-based sample. Methods We conducted retrospective pharmacoepidemiology of de-identified medication administration e-records from December 1st 2016 to December 31st 2017. Four tiers of de-identified data were collected: RAC home level data (ownership, levels of care), care staff level data (competency level/role), resident data (gender, age, level of care), and medication related data (omissions, categories of omissions, recorded reasons for omission). Data were analysed using SPSS version 24 and Microsoft Excel.Results A total of 11, 015 residents from 374 RAC homes had active medication charts; 8,020 resided in care over the entire sample timeframe. A mean rate of 3.59 medication doses were omitted per 100 (±7.43) dispensed doses/resident. Seventy-three percent of residents had at least one dose omission. The most common omission category used was ‘not-administered’ (49.9%), followed by ‘refused’ (34.6%). The relationship between ownership type and mean rate of omission was significant (p=0.002), corporate operated RAC homes had a slightly higher mean (3.73 versus 3.33), with greater variation. The most commonly omitted medications were Analgesics and Laxatives. Forty-eight percent of all dose omissions were recorded without a comment justifying the omission. Conclusions This unique study is the first to report rate of medication omissions per RAC resident over a one-year timeframe. Although the proportion of medications omitted reported in this study is less than previously reported by hospital-based studies, there is a significant relationship between a resident’s level of care, RAC home ownership types, and the rate of omission.

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