Article: A programme to cut inappropriate use of non-sterile medical gloves

Healthcare workers should only use non-sterile gloves for self-protection when exposure to blood or body fluids is likely. Overuse of gloves can have negative repercussions, including higher expenditure and waste, more skin problems and missed opportunities to decontaminate hands.

Dunn, H. et al. 2019. A programme to cut inappropriate use of non-sterile medical gloves, Nursing Times, 115(9), p18-20.

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Article: Staffing a specialist palliative care service

Calculating staffing needs for specialist palliative care services is complex, and there is little published evidence to suggest best practice.  This Canadian article written by the Canadian Society of Palliative Care is based on the interdependence of three key professional roles, an extensive literature search, key stakeholders and expert opinion. It recommends a number of starting points that will be evaluated as it's implemented across Canada.

Henderson, J. et al. 2019. Staffing a Specialist Palliative Care Service, a Team-based Approach: Expert Consensus White Paper. Journal of Palliative Care 22(11) p1318-1322.

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Article: Digital legacies with people affected by motor neurone disease

Little is known about how to best support young people (24 years and under) when a family members dies form motor neurone disease.  One potential solution is through use of a digital legacy whereby videos which documents a person's life memorial and achievements are purposely recorded by an adult during their illness.  This study aimed to investigate whether this supports or hinders a young persons' bereavement.  Twenty healthcare professionals, specialists and experts were recruited and interviewed in their work place or by telephone. It found the use of digital legacies to be a feasible and valuable method to support young people bereaved as a result of motor neurone disease.

Clabburn, O. et al.  2019. Digital legacies with people affected by motor neurone disease: The views, experiences and perceptions of healthcare professionals, specialists and experts for use with bereaved young people. Bereavement Care; 2019; vol. 38 (no. 2-3); p. 68- 75.

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Report: Fresh eyes approach: a walkthrough to improve people's experience of care in the last months of life in acute hospitals. Family and carers' perspectives

This report summarises our learning from our ‘fresh eyes’ walkthroughs of 12 acute hospital trusts, a key component of the programes approach to consider the patient, family and/or carers’ experiences by walking through a potential journey.

Hospice UK, 2019.  Fresh eyes approach. A walkthrough to improve people's experience of care in the last months of life in acute hospitals. Family and carers' perspectives.

Available online or request a copy from the library

Report: Fresh eyes approach: caring to the end - shining a spotlight on bereavement and mortuary services

The Fresh Eyes method is part of a Hospice UK and NHS End of life Care project to improve care for patients at end of life, cared for in acute NHS hospitals.  It undertakes a "walk through" of a potential patient / relatives journey. This report summarises Hospice UK’s learning from their walk through of post death care, bereavement centres and mortuary services in 12 acute hospital trusts across England, taking part in two end of life care hospital improvement programmes supplemented with an analysis of mortality data.  Published November 2019.

Download report here

Report: The current state of caring for family carers in UK hospices

Published November 2019, the report summarises the state of carer assessment and support provision across the hospice sector in the UK.

Higgerson, J. et al. The current state of caring for family carers in UK hospices: findings from the Hospice UK Organisational Survey of Carer Assessment and Support.  Hospice UK,  2019.

Available from the Hospice UK web site or request a copy from the library

Article: Do the Welsh have it? Evaluating a bereavement support service supporting people bereaved by dementia

Research has shown that carers who report higher levels of pre-death grief are at greater risk of complicated grief after their loved one has died.  The Bereaved by Dementia project was set up to address the bereavement needs of people bereaved by dementia throughout Wales.  This report summaries the findings, recommendations and suggestions for future research.

Roleston, C, et al. 2019.  Do the Welsh have it?  Evaluating a bereavement support service supportive people bereaved by dementia.  Bereavement Care, 38 (2-3) p 104-108

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Article: UK Childhood bereavement services:

This paper is a reflection on the development of childhood bereavement services.  It describes the early days of service growth, outlines three challenges the services currently face before considering their impact on the wellbeing of bereaved children.

Rolls, L. 2019. UK childhood bereavement services: A reflection on their development and cultural influence.   Bereavement Care, 2019, 38 (2-3) p 91-103.

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Article: Pressure ulcer education 1: introducing a new core curriculum

In spite of prevention programmes, pressure ulcers (PU's) remain a major health problem.  Staff education has been shown to be key to prevention.  This article discusses a new core curriculum for PU prevention and management.  It describes the content, how it was developed, and it's use in academic and clinical settings to support individual learning.

Fletcher, J. 2019.  Pressure ulcer education 1: introducing a new core curriculum.  Nursing Times, 115 (11) p 18-19.

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Article: Pressure ulcer education 2: assessing patients' risk of pressure ulcers

Risk assessment is the first step in pressure ulcer prevention to identify patients most at risk, plan and implement interventions, and ensure resources are used appropriately. This article outlines the key factors in assessing risk for effective pressure ulcer prevention.

Young, C. Fletcher, J. 2019 Pressure ulcer education 2: assessing patients' risk of pressure ulcers. Nursing Times, 115(11) p20-22.

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Article: Pressure ulcer education 3: skin assessment and care.

This article highlights what practitioners need to know about risk factors associated with impaired skin integrity, how to check for non-blanchable erythema, and evidence-based interventions to promoted skin integrity and prevent pressure ulcers.

Fletcher, J. 2019. Pressure ulcer education 3: skin assessment and care. Nursing Times, 115(12) p26-29.

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Article: Hierarchy disruptors: bringing specialist knowledge from hospital to community care

This article discusses Project ECHO, now widely used by Hospice UK to facilitate a learning community across many countries.  The article looks at how it could be used in the NHS.

Eaton, L. 2019. Hierarchy disruptors: bringing specialist knowledge from hospital to community care. British Medical Journal (Online); Jun 2019; vol. 365

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Article: The experiences of family members witnessing the diminishing drinking of a dying relative

This systematic review looked at the current research knowledge of family members'  experiences of witnessing the diminishing drinking of dying patients.  Their findings revealed that family members views varied about the significance of the drinking, patient characteristics, the care environment, and their expectations of care by themselves and professionals.

Pettifer, A. et al. 2019. The experiences of family members witnessing the diminishing drinking of a dying relative: an adapted meta-narrative literature review. Palliative Medicine, 33 (9) p 1146-1157.

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Information for families: when death is near

This article from the Canadian web site Virtual Hospice is a well written piece about the last few days/hours when someone is dying.  It describes what will happen, and common concerns from families.  It covers decreasing energy, decreasing food and fluids, confusion, agitation, "visions", and the final physical changes in the body, including skin changes, breathing changes and when death has happened.
Download here

NICE Guidance: End of life care for adults: service delivery (NG142)

This guideline describes the provision of end of life care services for adults approaching the end of their life with any condition and disease.  It advises on service models for care in acute settings by disease-specific specialists and their supportive services, and in community settings by primary care or specialists in palliative care (for example, in hospices).  It is intended to be used alongside the NICE guidelines on Care of dying adults in the last days of life.

Download guidance here

Article: Volunteers in a biography project with palliative care patients

This German study looked at the feasibility of training hospice volunteers in biography work.  The study evaluated the time required for training, co-ordination and supervision, outcomes, and risks, such as causing distress to patients or volunteers. Nine volunteers took part, completing questionnaires before the training and after the completion of biography work with a patient.  Patients provided positive feedback from the intervention.  For volunteers, it was personally rewarding.  There were no problems or negative experiences reported by either volunteers or patients.  The article records the interviews with volunteers before and after the training.

Hesse, M. 2019. Volunteers in a biography project with palliative care patients - a feasibility study.  BMC Palliative Care. 
Download here

Recording hospice patients life stories

Since November 2017, St Leonard’s has been working in partnership with the Hospice Biographers charity and in October 2019 announced that the service is officially up and running. A range of St Leonard’s staff and two volunteers undertook specialist training in June this year to enable them to work with patients to prepare and record their biography.
Read more here

Article: What do relatives value most in end-of-life care for people with dementia

End of life care for people with dementia is often sub-optimal. This Dutch piece of research compared the experience of end of life care from the relatives perspective, comparing the home setting to a nursing home. Thirty-two bereaved individuals took part in the study.  Four key themes emerged from the interviews: acknowledging human dignity; being recognised as an important care giver; not talking about death and dying; and making decisions together. Recommendations for nursing homes were particularly to learn to offer the same standard of person-centred care as the home setting and ensure relatives are still involved in care.

Bolt, S. 2019. What do relatives value most in end-of-life care for people with dementia.   International Journal of Palliative Nursing, 25 (9) p 432 - 435.

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Child Bereavement UK: An updated range of resources for children and families

Child Bereavement UK have updated their range of leaflets supporting children when someone has died. The leaflets are very well written and very useful for both staff and families. They include:

When someone is not expected to live: supporting children

Explaining to young children that someone has died

Children's understand of death at different ages

Viewing a body with a child

Explaining funerals, burials, and cremation to children

Supporting bereaved children under 5 years of age

How children and young people grieve

What helps grieving children and young people

Supporting bereaved children and young people with additional needs through grief

When a grandparent dies: the impact on children and young people

Article: Team approaches in palliative care: a review of the literature

This article reviewed the literature on palliative care teams with a view of how and when they function best.  Emphasis is also placed on studies that suggest ways to mitigate the conflicts and limitations of team work.  Their findings strongly suggest that palliative care is best delivered through a multidisciplinary team approach.   The overall performance of a team they noted is largely determined by the supportive work environment built through effective  communication, leadership skills and mutual respect.

Fernando, GVMC. & Hughes, S. 2019. Team approaches in palliative care: a review of the literature.  International Journal of Palliative Nursing, 25 (9) p 444-450

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Article: Hospice at Home services in England: a national survey

Hospice at Home (HAH) services aim to enable patients to be cared for and die at home.  A national survey was carried out in 2017 with the aim to describe and compare the features of HAH services and understand the key enablers to service provision.  Information on service models, referral, staffing, finance, care provision and enablers to service provision was collected by telephone interview. 128  services were contacted with 70 (54.7%) providing data.  Considerable variation was found in HAH services and further work defining service features related to patient and carer outcomes would support future service development.  On going in depth evaluation of 12 of these HAH services will aid this understanding and shape recommendations for commissions and future providers.

Rees-Roberts, M. 2019. Hospice at Home services in England: a national survey.  BMJ Supportive & Palliative Care, epub 20.11.2019.

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Article - A step towards getting wound care right - first time.

Getting it Right First Time (GIRFT), is the national programme designed to improve medical care within the NHS by reducing unwarranted variations in practice.  This article, written by a group of tissue viability specialists used the GIRFT programme to consider how healthcare professionals and industry, working together can help to prevent the variations in wound care that currently exist.

Bethell, E. et al. 2019.  A step towards getting wound care right - first time.  Journal of Community  Nursing, 33 (5) p 63.

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Article: Comparison of financial support for family care givers of people at the end of life across six countries

The aim of this research was to identify and compare sources of support for family caregivers of people approaching end of life across six countries with similarly performing healthcare systems.  The 6 countries were Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. The study found some form of financial support is available in all six countries, however the type, extent, and reach of support vary. The support is administered by multiple agencies, eligibility criteria are numerous and complex, and there is considerable inequity in the provision.  The authors concluded there is significant potential for policy makers to learn from other countries experiences.

Gardiner, C. 2019.  Comparison of financial support for family care givers of people at the end of life across six countries: a descriptive study.  Palliative Medicine, 33 (9) p1189-1211.

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Article: Patients' needs regarding anxiety management in palliative care

This Dutch study aimed to get insight into the support needs of anxious hospice patients with advanced cancer.  14 patients were included in the study and 13 interviewed within 6 months of their death.  Information,  open communication, a sense of control, safety, adequate symptom management and respect for patients' coping strategy were the 6 main expressed needs.  The authors conclude healthcare professionals can make a significant contribution in supporting anxious patients before death with further research focusing on the development of a systematic approach to this.

Zweers, D. 2019.  Patients' needs regarding anxiety management in palliative cancer care: a qualitative study in a hospice setting.  American Journal of Hospice and Palliative Medicine.  36 (11) p 947-954.

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Article: Communication between healthcare professionals and relatives of patients approaching the end-of-life

Effective communication between healthcare professionals and relatives is vital to ensure patients have a "good death". This study sought to establish what the current practice is.  31 papers were included in the review. 7 themes were identified from them with varied levels of family involvement in the decision making process. Doctors were regarded as responsible for discussing prognosis and decision making and nurses for providing individualised care.  Findings suggest training could provide healthcare professionals with strategies to improve communication such as question prompt lists could help relatives overcome barriers to involvement in decision-making.

Anderson, R. J. et al. 2019. Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence.  Palliative Medicine 33 (8) p 926-941.

Article: Development of a hospice research culture through staff development, education and collaboration

Over the last 2 years the Marie Curie Hospice Liverpool has developed a series of quality improvement initiatives to establish a UK hospice research culture and improve research opportunities.  This short article describes how this was implemented.

Stanley, S. 2019. Development of a hospice research culture through staff development, education and collaboration.  BMJ: Supportive and Palliative Care,

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Article: "I want to die in my sleep" - how people think about death, choice and control

This Australian study sought to explore societal and personal wishes and beliefs around death and dying.  Participants posted comments in a Massive Open Online Course (MOOC) on death and dying, entitled Dying2Learn.  For one activity in the MOOC, participants responded to a question asking them about "the best way to go".  The analysis showed that although death was considered a natural and normal process it was accompanied by deep reluctance to address the physical process of dying. Their findings highlighted a desire for choice and control in relation to dying, a common element in discussions of both advance care planning and palliative care.  The paper discusses the paradox of individuals wanting to have control whilst preferring not to know they are dying.

Sanderson, C. 2019. "I want to die in my sleep" - how people think about death, choice and control: findings from a Massive Open Online Course (MOOC).  Annals of Palliative Medicine, 8 (4) p 411-419.

Contact the library for a copy.