Article: Achieving successful subcutaneous access in palliative care

Subcutaneous administration of medications is a well-recognised route for delivering prescribed therapies, in particular analgesia for patients requiring palliative care. This article discusses how technological developments are resulting in subcutaneous access devices that are easy to insert and can meet the needs of a growing population, as well as complying with the latest guidelines on sharps safety. 

Gabriel, J. 2018. Achieving successful subcutaneous access in palliative care.  International Journal of Palliative Nursing, 24 (6) p 282 - 287.

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Article: Safe and effective use of supplemental oxygen therapy

This article provides an overview of the anatomy and physiology in relation to oxygen delivery to the lungs and tissues in the body and outlines the common indications and contraindications for supplemental oxygen delivery.  It also discusses the approaches health care staff can adopt to assess a patient's clinical need as well as the safety considerations required.  A good article for CPD, and could be used for nurses undergoing revalidation.  It includes a multiple choice quiz at the end.

Allibone, E. 2018.  Safe and effective use of supplemental oxygen therapy.  Nursing Standard, 33 (5) p 43 - 49.

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Article: Effective management of hypoglycaemia

Hypoglycaemia is a potentially serious complication of diabetes mellitus in which an individual's blood glucose drops to dangerously low levels.  The aim of this article is to assist healthcare assistants and nurses to work collaboratively with patients and their families and carers in the prevention and management of hypoglycaemia.  A good article for CPD, and could be used for nurses undergoing revalidation.  It includes a multiple choice quiz at the end.

Smyth, T. 2018. Effective management of hypoglycaemia.  Nursing Standard, 33 (5) p 59 - 65

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Article: Breakthrough cancer pain (BTcP) management: a review of international and national guidelines

Ten specific BTcP guidelines were reviewed in this study, as well as major generic cancer pain guidelines.  In general there was good agreement between the guidelines, however the evidence remains of low grade and more research is needed in this area.  They also identified there needs to be international consensus on the definition and diagnosis of BTcP.

Davies, A. et al. 2018.  Breakthrough cancer pain (BTcP) management: a review of international and national guidelines.  BMJ Supportive & Palliative Care,  8 p 241 - 246.

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Article: Impact of specialist palliative care on coping with Parkinson's disease: patients and carers

UK guidelines recommend palliative care access for people with Parkinson's disease, however it remains sporadic.  Using semi-structured interviews, participants were patients with advanced Parkinson's disease and their carers.  The study found that access to specialist palliative care helped patients and carers cope in particular with managing uncertainty; impacts on the self; and maintaining a positive outlook.

Bader, N. 2018. Article: Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.  BMJ Supportive and Palliative Care 8 p 180 - 184.

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Article: The facilitators and challenges of dying at home with dementia: a narrative synthesis

Public surveys report that most people, given the choice would prefer to die in their homes, yet people with dementia rarely achieve this.  This UK research searched the literature to establish what factors influence death at home and found support from healthcare professionals, carer resilience, extended social networks, support with medication and symptom management, and appropriate equipment and home adaptations all facilitated dying at home.  The challenges included issues with formal services and deteriorating physical and mental health.  The research revealed there was comparatively little research in this area.

Morgan, C. et al.  2018.  The facilitators and challenges of dying at home with dementia: a narrative synthesis.   Palliative Medicine, 32 (6) p 1042 - 1054.

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Article: Managing an intentional overdose in a hospice

This case report describes a patient admitted unconscious to a UK hospice following an intentional overdose of oxycodone.  It illustrates the practical and ethical challenges of managing an intentional overdose in a palliative care setting.

Dinnen, T. 2018.   Managing an intentional overdose in a hospice.  BMJ Supportive and Palliative Care. 8 p 189 - 191.

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New Book: Medicines management for nurses at a glance

Written specifically for nurses, the book is divided into three sections, the first introduces key topics within clinical pharmacology and medicines management including, numeracy, pharmacokinetics, routes of administration, and pharmacodynamics. The second and final sections cover the management of medicines for common medical conditions, drug interactions, side effects, and safe and effective prescribing.

Young, S. & Pitcher B. 2016.  Medicines management for nurses at a glance.  Wiley Blackwell.

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New Book: Infection prevention and control at a glance

This highly visual and dynamic book is a thorough resource for healthcare staff wanting to consolidate and expand their knowledge in infection prevention and control. It provides a concise and simple approach to a vast and complex subject, and equips the reader with key information in relation to aspects of infection control.

Weston, D. et al. 2017.  Infection prevention and control at a glance.  Wiley Blackwell.

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New Book: Palliative care nursing at a glance

Written by an expert team of nurses, educators, academics and researches, the book provides a concise and easy to read overview of all the concepts and clinical decision making necessary for the provision of good quality palliative and end of life care.  Covers a wide range of conditions including heart failure, COPD, kidney disease, motor neurone disease, mental illness and learning disabilities.

Ingleton, C. & Larkin, P. J. 2015. Palliative care nursing at a glance.  Wiley Blackwell.

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Article: What is the cost of palliative care in the UK? A systematic review

Little is known about the cost of a palliative care approach in the UK, and there is an absence of robust activity and unit cost data.  The aim of this paper was to explore different approaches for capturing activity and unit cost data. Ten  papers were identified which met the study inclusion criteria.  The majority of papers explored costs from a NHS perspective.  Particular challenges were noted with capturing activity and cost data for hospice care.  The authors were not able to provide an aggregate cost of palliative care in the UK and noted the costs of hospice care and informal care are often neglected in economic studies.

Gardiner, C. et al. 2018.  What is the cost of palliative care in the UK?  A systematic review.  BMJ Supportive & Palliative Care. 8 250 - 254.

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Article: Meeting the needs of young adults with life-limiting conditions: A UK survey of current provision and future challenges for hospices

The aim of this study was to seek the views of UK children's and adult hospices on the availability and challenges of providing services for the 55,721 young adults between the ages of 18 - 40 with life-limiting conditions and/or complex needs which are degenerative, progressive and diverse.  The data was collected in 2016 from 76 hospices via an online survey.  The survey findings showed a lack of existing adult respite  services; lack of funding and capacity; lack of skilled workforce in adult hospices; and the need for better integrated service provision.  There were examples of good collaborative working but with an increasing population of young adults and pressure on families, it is vital that services work together to find sustainable solutions.

Knighting, K. et al. 2018. Meeting the needs of young adults with life-limiting conditions: A UK survey of current provision and future challenges for hospices.  Journal of Advanced Nursing, May 2018 (epub)

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Article: Mending the heart and mind during times of loss: a review of interventions to improve emotional well-being during spousal bereavement

An article from the US, it reviews evidence for current pharmacological and psychotherapeutic approaches to normal bereavement, complicated grief, and bereavement related depression.  It then explores novel interventions to promote adaptive emotion regulation and reduce depressive symptoms.

Shahane, A. et al. 2018. Mending the heart and mind during times of loss: a review of interventions to improve emotional well-being during spousal bereavement.  Bereavement Care, 37 (2) p 44 - 54.

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Article: Supporting parents and children prior to parental death in an NHS Setting

This article discusses the work at a Scottish Hospice to enable parents to prepare themselves and their children for parental dying.  It discusses the need to work as early as possible through each stage of the bereavement journey and working with school staff and other services to ensure that everyone concerned has the information they need to support the children and young people concerned.

Macpherson, C. 2018. Supporting parents and children prior to parental death in an NHS Setting.  Bereavement Care, 37 (2) p 67 - 73.

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Article: Lived experiences of singing in a community hospice bereavement support music therapy group

This study, from a Canadian Hospice examined the singing experiences of seven women who participated in a bereavement support music therapy group.  The participants wrote feedback after each singing group session providing a narrative of their experiences and the benefits they felt it brought them.

Young, L. & Pringle, A. 2018.  Lived experiences of singing in a community hospice bereavement support music therapy group.  Bereavement Care, 37 (2) p 55 - 66.

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Article: Song of Life: music therapy in terminally ill patients with cancer

This aim of this pilot study was to assess the feasibility, acceptance and potential effectiveness of a novel music therapy intervention to improve life closure and spiritual well-being of terminally ill patients with cancer receiving palliative care.  Fifteen patients participated.  The intervention consisted of two sessions, containing a biographical interview and a live performance of a song with high relevance to the patients in a lullaby style.  The results showed medium-sized improvements with regard to life closure, well being, relaxation, worry and pain.  The authors conclude further consideration with regard to procedures and outcomes is necessary before implementation of a randomised trial. 

Warth, M. et al. 2018. "Song of Life": music therapy in terminally ill patients with cancer.  BMJ Supportive & Palliative Care, 8 (2) p 167 - 170.

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Article: Music therapy in a UK palliative and end of life care setting: a service evaluation

A survey was sent to the British Association of Music Therapists to identify the provision, role and perceived impact of music therapy in palliative care settings.  Fifty respondents replied working predominantly in adult neurological, cancer and dementia settings, providing information on format of sessions, therapeutic approaches, therapeutic goals and impact.   Only a minority received statutory state funding for their role.  The survey respondents commonly cited improving quality of life as a goal of care.  The authors noted that a stronger evidence base could encourage more consistent funding for this role.

Graham-Wisener L, Watts G, Kirkwood J, et al.  Music therapy in UK palliative and end-of-life care: a service evaluation.  BMJ Supportive & Palliative Care Published Online First: 22 February 2018.

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Article: Why we need more poetry in palliative care

Within palliative care there has been a long standing interest in how poetry may help patients and health care staff  find meaning, solace and enjoyment.  This paper aims to identify the different ways in which poetry has been used in palliative care and reflect on its further potential for education, practice and research.

Davies, E. 2018.  Why we need more poetry in palliative care.  BMJ: Supportive & Palliative Care, 8 (3) p 226 - 267.

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