Education and training to enhance end of life care for nursing home staff: a systematic literature review

Anstey, Sally ORCID: https://orcid.org/0000-0003-2295-3761, Powell, Tom, Coles, Bernadette ORCID: https://orcid.org/0000-0003-0695-2865, Hale, Rachel ORCID: https://orcid.org/0000-0003-4248-0391 and Gould, Dinah ORCID: https://orcid.org/0000-0002-1506-9532 2016. Education and training to enhance end of life care for nursing home staff: a systematic literature review. BMJ Supportive and Palliative Care 6 (3) , pp. 353-361. 10.1136/bmjspcare-2015-000956

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Abstract

Background The delivery of end-of-life care in nursing homes is challenging. This situation is of concern as 20% of the population die in this setting. Commonly reported reasons include limited access to medical care, inadequate clinical leadership and poor communication between nursing home and medical staff. Education for nursing home staff is suggested as the most important way of overcoming these obstacles. Objectives To identify educational interventions to enhance end-of-life care for nursing home staff and to identify types of study designs and outcomes to indicate success and benchmark interventions against recent international guidelines for education for palliative and end-of-life care. Design Thirteen databases and reference lists of key journals were searched from the inception of each up to September 2014. Included studies were appraised for quality and data were synthesised thematically. Results Twenty-one studies were reviewed. Methodological quality was poor. Education was not of a standard that could be expected to alter clinical behaviour and was evaluated mainly from the perspectives of staff: self-reported increase in knowledge, skills and confidence delivering care rather than direct evidence of impact on clinical practice and patient outcomes. Follow-up was often short term, and despite sound economic arguments for delivering effective end-of-life care to reduce burden on the health service, no economic analyses were reported. Conclusions There is a clear and urgent need to design educational interventions that have the potential to improve end-of-life care in nursing homes. Robust evaluation of these interventions should include impact on residents, families and staff and include economic analysis.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RT Nursing
Additional Information:	This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license
Publisher:	BMJ Publishing Group
ISSN:	2045-435X
Date of First Compliant Deposit:	8 November 2016
Date of Acceptance:	5 May 2016
Last Modified:	18 Sep 2023 11:35
URI:	https://orca.cardiff.ac.uk/id/eprint/91538

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