Article: Palliative care for patients with motor neurone disease and their bereaved carers

This study examined the end of life care for people with motor neurone disease (MND) in Northern Ireland and the role of specialist and general palliative care.  13 bereaved carers of patients who had died 3 - 24 months previously with a diagnosis of MND were recruited to the study.  The study found variations in the levels of holistic care provided, with unmanaged respiratory and psychological symptoms causing the most distress.  Many patients had shown great reluctance to engage with specialist palliative care services, although for those who did, it was felt to be of great benefit. 

McVeigh, C. 2019. Palliative care for patients with motor neurone disease and their bereaved carers. BMC Palliative Care, online,

Available to download

Article: Reiki therapy for pain, anxiety and quality

This French study reviewed the literature on the use of Reiki therapy in palliative care and in particular on pain, anxiety, depression and quality of life.  It revealed there have been very few studies carried out that could clearly identity the benefits, but preliminary results tended to show some positive effects of the therapy in end of life populations.  It discusses what Reiki therapy consists of, and the research available so far in each of these 4 areas and hopes the results will encourage palliative care teams to carry out their own research.

Billot, M. et al. 2019.  Reiki therapy for pain, anxiety and quality.  BMJ: Supportive & Palliative Care, online p 1-5.

Contact the library for a copy.

RCN Guidance: Safeguarding children and young people

All healthcare staff must have the competencies to recognise child maltreatment, opportunities to improve childhood wellbeing, and to take effective action as appropriate to their role. This intercollegiate guidance provides a clear framework which identifies the competencies required for all healthcare staff.   The framework also includes specific detail for chief executives, chairs, and board members including executives, non-executives and lay members.

RCN: Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff.

Download here

eHospice: Workforce and learning development in hospices

Anita Hayes, the new Head of Learning and Workforce at Hospice UK, rounds up seven top tips to help support workforce learning in hospices.

Read more here

New Books: Team Building ~ Motivating Staff ~ Delegation

Part of the Speed Reads series, a range of very accessible and easy to read books, particularly useful for new team leaders or new in a management role:

Motivating staff - this book aims to support managers create the right conditions to get the best from their team.  32 pages.

Team Building - provides guidance to ensure that team building works well and as a result you get the best from your team. 32 pages.

Delegation - aimed at team leaders who are responsible for the performance of others.  Particularly recommended for those who find it hard to delegate.  32 pages.

Contact the library for a loan.

New Books: Presentations ~ Interviewing ~ Training Skills

A range of books known as Speed Reads, all available on loan from the library.

Presentations - this book will help you deliver presentations, speeches, and other public speaking with confidence and flair.  32 pages.

Interviewing - with this book you'll learn how to make good interviewing a useful and informative part of the recruitment process, rather than a scary and uncomfortable ordeal. 32 pagses

Training Skills  - offers practical tools and templates to run good training sessions.  32 pages.


Contact the library for a loan.

Article: Dog handlers' experiences of therapy dogs' impact on life near death for persons with dementia

Swedish research looking at the positive impact the interaction between dogs and individuals with dementia towards the end of life can bring.

Swall, A. et al. 2019.  Dog handlers' experiences of therapy dogs' impact on life near death for persons with dementia.  International Journal of Palliative Nursing, 25 (2) p 65 - 68.

Contact the library for a copy

Article: Palliative care in dementia: a fragmented pathway

This paper describes the Admiral Nurse case management approach to palliative care by benchmarking its practice against the European Association of Palliative Care white paper recommendations for palliative care in dementia.

Harrison Dening et al.  2019.  Palliative care in dementia: a fragmented pathway.  International Journal of Palliative Nursing, 585 - 588.

Contact the library for a copy

Article: Understanding care when cure is not likely for young adults who face cancer

Three cancer centres and associated palliative care services across England were the setting for this research which comprised of interviews and six workshops. 3 people aged 16 - 24 years and 30 people aged 25 - 40 years with a prognosis of under 12 months took part in this study along with family members and 47 healthcare professionals.   The data revealed seven key themes which included loss of control; maintenance of normal life; support for families and importance of language chosen by professionals.  The authors conclude current care towards end of life for young people and families doesn't meet needs and expectations.

Kenten, C. 2019.  Understanding care when cure is not likely for young adults who face cancer: a realistic analysis of data from patients, families and healthcare professionals.  BMJ, online

Contact the library for a copy

Report: A reflective group activity supports healthcare staff in England

Working in healthcare can be demanding and stressful.  The National Institute for Health Research (NIHR) conducted this research looking at the effective of Schwartz Rounds - a forum for clinical and non clinical teams to share stories and discuss the emotional impact of delivering healthcare.  The research showed that overtime staff participating in the sessions felt less stressed and isolated and more empathetic when dealing with patients and colleagues. It offers one of the few evidence based interventions that work at both organisational and person centred level.

Read more here

eHospice: New study calls for improvements in out of hours palliative care

From eHospice, a piece discussing the new research by Marie Curie and the RCGP calling for improvements in out of hours palliative care.  Using the NHS  National Reporting and Learning System, the research explored the nature and causes of unsafe care delivered to patients receiving palliative care from primary care services.  A total of 1072 patient safety incident reports were identified.  A number of recommendations are made.

View eHospice pages here

For a copy of the research - contact the library. 

Article: What do patients and family-caregivers value from hospice care?

It is not known what attributes of care are valued the most by those who experience hospice services.  This systematic review identified 34 studies that had addressed some of these questions.  The findings provided new insights beyond symptom management and health outcomes.  Of particular importance was the social value placed on services that are usually only provided by hospices, such as highly individualised care, befriending, social support meaningful occupation and bereavement support.

Hughes, N. M. et al. 2019. What do patients and family-caregivers value from hospice care?  A systematic mixed studies review.  BMC Palliative Care

Access article here

Article: Delirium management by palliative medicine specialists

Delirium is common in palliative care.  A 21 question online anonymous survey was emailed to APPM members in current clinical practice (n=859) asking about delirium assessment, management and research priorities.  The response rate was 39%.  Delirium guidelines were used by some: 42% used local guidelines but 38% used none.  The survey showed delirium screening on admission is suboptimal, with most specialists using antipsychotics in combination with non-pharmacological interventions.  More support is required for family members along with clinical trials in view of the variation in management.

Boland, J. W. 2019. Delirium management by palliative medicine specialists: a survey from the association for palliative medicine of Great Britain and Ireland.  BMJ Supportive & Palliative Care,  March 2019 - online p 1-8.

Contact the library for a copy

Guidance: Care after death - registered nurse verification of death

This guidance is an update to the original 2015 guidance and is aimed at providing greater clarity on the legal requirements for Registered Nurses about the verification of expected deaths.  The two part resource also includes new competencies to support training to carry this very important aspect of care.

Hospice UK, 2019.  Care after death: registered nurses verification of death.
  
Access via the Hospice UK pages  or contact the library for a copy.

Guidance: Care Committed To Me

This report by Hospice UK focuses on 3 specific groups: Lesbian, Gay, Bisexual and Transgender (LGBT) people, those experiencing homelessness, and Gypsies and Travellers.  It discusses how commissioners, service providers and care staff can successfully deliver high quality, personalised care to people from these groups by taking proactive measures to overcome many of the challenges that prevent them receiving the care they need.

Hospice UK, December 2018.  Care Committed to Me.  Hospice UK.
  
Access via the Hospice UK pages  or contact the library for a copy.

Article: The power of two simple questions - enhancing patient centred care

The authors of this article devised this simple spiritual care model for the acute settings .  They explain how it works and enhances person-centred practice.  It consists of two simple questions: what is most important to you now? and how can we help?  Examples are provided how it can be used throughout a busy care shift.

Ross, L. & McSherry W. 2018. The power of two simple questions.  Nursing Standard, 33 (9) p 79 - 80.

Contact the library for a copy

Article: Mapping the scope of occupational therapy practice in palliative care

The role of the occupational therapy in palliative care service delivery has evolved over several decades, with the role more established in some countries than others.  A survey was hosted on the European Association for Palliative Care (EAPC) web site to scope the extent of occupational therapy interventions in palliative care.  237 replies were received.  The study provided evidence of a consistency of practice, with an emphasis on physical, functional, psychological and social aspects of care.  There was limited involvement in service development, leadership and research.

Eva, G. & Morgan, D. 2018. Mapping the scope of occupational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey.  Palliative Medicine, 32 (5) p 960-968.

Access article here

Article: Engaging leadership - a better approach to leading a team?

This article explains how a specific approach to leadership, called Engaging Transformational Leadership provides a framework for nursing leaders to reduce staff stress, improve teamwork, innovation and collaboration.

Alban-Metcalfe, J. & Alimo-Metcalfe, 2018.   Engaging leadership - a better approach to leading a team?  Nursing Times, 114 (6) p 21 - 24

Contact the library for a copy

Article: Prevention and management of moisture-associated skin damage

The term moisture associated skin damage describes the spectrum of inflammatory damage that occurs in response to prolonged exposure of patents' skin to perspiration, urine, faces or wound exudate.  This article  describes the conditions this can cause and the nursing interventions required for their prevention and management.

Voegili, D. 2019.  Prevention and management of moisture-associated skin damage.  Nursing Standard, 34 (2) p 77 - 80

Contact the library for a copy

Article: Palliative care in motor neurone disease: where are we now?

The article discusses the role of palliative care in motor neurone disease.  Guidance includes the telling of the diagnosis to the patient and family, assessment and management of symptoms, consideration of interventions, such as gastrostomy and ventilatory support and care at the end of life.

Oliver, David. 2019.  Palliative care in motor neurone disease: where are we now?  Palliative Care: Research and Treatment, p 1- 14 online.

Access article here

Article: The rationale for making a short DVD in relation to the last offices procedure

Produced for student nurses who had previously reported feeling unprepared emotionally to undertake this task, the article reports on the effectiveness of using a DVD to prepare students for the death of a patient during their first clinical placement.

Parry, M. & Jones, B. 2019 The rationale for making a short DVD in relation to the last offices procedure.  International Journal of Palliative Nursing, 25 (2) p 91-94.

Contact the library for a copy

Article: Improving the approach to future care planning in care homes

In the UK advance care planning (ACP) is an important element of palliative care and it's use is encouraged in nursing care homes.  This article reviews a document called the Personalised Advisory Care (PEACE) plan and reports on an audit carried out in one care home following it's use.  All of the residents (n=8) with a PEACE plan who died, did so in their preferred place of death, compared to 50% of residents (3 out of 6) without a PEACE who died in their preferred place of care.  The authors recommend future care planning, rather than ACP is required in nursing care homes along with further research investigating the outcomes and cost effectiveness.

Kinley, J. et al. 2018.  Improving the approach to future care planning in care homes.  International Journal of Palliative Care Nursing, 24 (12) p 576 - 579.

Contact the library for a copy

Article: Malignant hypercalcaemia: definition, symptoms and treatment

Hypercalcaemia - an abnormally high level of calcium in the blood - is common in advanced cancer. It can often be successfully treated, whether with bisphosphonates or the monoclonal antibody denosumab, and the side-effects of treatment can often be managed. However, many patients face the challenges posed by other burdensome symptoms of malignant disease and a poor prognosis. This article provides an extensive overview of malignant hypercalcaemia, including its causes, symptoms, treatment and implications for nursing practice.

Beland, P. 2018. Malignant hypercalcaemia: definition, symptoms and treatment. Nursing Times, 114 (11) p 40-44.

Article: Listening to the family's voice: evaluation of a tool to improve symptom control and communication

Hospitals will remain the most common place of death for the foreseeable future and there is a need to improve the experience of dying in hospital. This article evaluates the use of a Family's Voice (FV) diary to aid communication between clinical staff and relatives.  Nine sites took part in the study, consisting of 7 acute trusts, an NHS hospice and a group of nursing homes. 112 diaries were completed.  Ten themes were identified following analysis of the diaries, and provided a good insight into what families observed and felt was important.  Some symptoms were managed better than others but overall families were positive about the care provided.  For hospices, where quality of care is already noted to be higher than in hospitals, the authors note further work is needed to explore whether the FV diary could be of use. 

McEvoy, M., Scott, E., Blenkinsopp, J., Hamilton, S. 2018. Listening to the family's voice: evaluation of a tool to improve symptom control and communication. International Journal of Palliative Nursing, 24(11) p 548.

Article: Anticipatory prescribing of injectable medications for adults at the end of life in the community

The anticipatory prescribing of injectable medications to provide end of life symptom relief is an established community practice in a number of countries. However, the evidence base to support this practice is unclear. An extensive literature search was carried out.   The results showed healthcare professionals believe anticipatory prescribing provides reassurance, effective symptom control and helps to prevent crisis hospital admissions. The attitudes of patients towards this remains unknown.  It was found to be a low cost intervention but there was inadequate evidence to draw conclusions about its impact on symptom control, comfort or crisis hospital admissions.  The authors conclude the views and experiences of patients and their family carers towards anticipatory prescribing need urgent investigation along with further research to investigate the impact on patients' symptoms, comfort, safety and hospital admissions.

Bowers, B. et al. 2018. Anticipatory prescribing of injectable medications for adults at the end of life in the community: a systematic literature review and narrative synthesis. Palliative Medicine, published online December 2018

Article: Timing of referral for hospice-based palliative care varies nationwide

This article reviews a retrospective study carried out looking at the timing of referral for palliative care to UK hospices.  64 hospices took part, representing a third of UK hospices, a mix of charity-managed and NHS managed sites, and varied in geographical location and size. The study found hospice care is introduced on average 48 days before death. Younger people and those with cancer were more likely to receive hospice care early in their illness trajectory. For people with dementia, the average time spent under hospice care was just nine days.  This study adds to the body of evidence describing inequalities in care for people who are dying. Research into models of care is needed to understand the potential solutions.

Timing of referral for hospice-based palliative care varies nationwide, November 2018, Nursing Times, 114 (11) p 52.

The full report can be accessed at the National Institute for Health Research (NIHR) -

Article: When is wound cleansing necessary and what solution should be used?

Routinely cleansing wounds at every dressing change can do more harm than good if the gauze swabs disrupt fragile tissue growth and damage new capillaries.  This article explains the circumstances in which it is appropriate to cleanse a wound.   It also discusses the re-emergence of antiseptic solutions - which are becoming more popular, particularly for infected or heavily contaminated wounds - and offers guidance on when to consider using them to cleanse wounds.

Brown, A. 2018. When is wound cleansing necessary and what solution should be used? Nursing Times, 114 (9) p 40-43.