Abstract
Background
Palliative Reasoning (PR), a stepwise symptom management approach, was developed to support healthcare professionals (HCPs) deliver optimal palliative care (PC). To enhance PC quality at home and improve team collaboration, PR requires further development and implementation within nursing teams.
Aim
The aim of this pilot study was to identify effective PR implementation strategies and evaluate study feasibility within district nursing teams providing palliative home care, to support a future randomized controlled trial.
Methods
A focused ethnographic pilot study using a participatory action research (PAR) approach was conducted to develop and implement PR in four district nursing teams. Data from questionnaires, patient chart reviews, and field notes from training and project meetings were collected to assess: 1) an implementation strategy for PR, 2) study procedures, 3) PR’s impact on communication and collaboration within nursing teams, and 4) collaboration with other healthcare professionals. All data were qualitatively analyzed.
Results
Three nursing teams completed the training, while one withdrew due to limited task maturity, focusing instead on basic care tasks. Three two-hour sessions with three-month intervals proved effective for PR education. Post-implementation: 1) collaboration improved within and between nursing teams and external HCPs, although not reflected in questionnaire results; 2) nursing team members felt more empowered and confident in their roles; 3) awareness of clients needing PC increased; and 4) documentation and measurement use showed no improvement. The pilot highlighted sustaining PR relevance as a key challenge for teams and management.
Discussion
Results suggest that identifying clients needing PC through the surprise question is an essential first step for district nursing teams to initiate the use of PR. Three two-hour training sessions, patient case discussions, and appointing contact persons as team champions proved effective to educate PR. Biweekly practice and monthly coaching help sustain PR’s relevance, supporting the feasibility of broader implementation in a cluster RCT.
Biography
Palliative Reasoning (PR), a stepwise symptom management approach, was developed to support healthcare professionals (HCPs) deliver optimal palliative care (PC). To enhance PC quality at home and improve team collaboration, PR requires further development and implementation within nursing teams.
Aim
The aim of this pilot study was to identify effective PR implementation strategies and evaluate study feasibility within district nursing teams providing palliative home care, to support a future randomized controlled trial.
Methods
A focused ethnographic pilot study using a participatory action research (PAR) approach was conducted to develop and implement PR in four district nursing teams. Data from questionnaires, patient chart reviews, and field notes from training and project meetings were collected to assess: 1) an implementation strategy for PR, 2) study procedures, 3) PR’s impact on communication and collaboration within nursing teams, and 4) collaboration with other healthcare professionals. All data were qualitatively analyzed.
Results
Three nursing teams completed the training, while one withdrew due to limited task maturity, focusing instead on basic care tasks. Three two-hour sessions with three-month intervals proved effective for PR education. Post-implementation: 1) collaboration improved within and between nursing teams and external HCPs, although not reflected in questionnaire results; 2) nursing team members felt more empowered and confident in their roles; 3) awareness of clients needing PC increased; and 4) documentation and measurement use showed no improvement. The pilot highlighted sustaining PR relevance as a key challenge for teams and management.
Discussion
Results suggest that identifying clients needing PC through the surprise question is an essential first step for district nursing teams to initiate the use of PR. Three two-hour training sessions, patient case discussions, and appointing contact persons as team champions proved effective to educate PR. Biweekly practice and monthly coaching help sustain PR’s relevance, supporting the feasibility of broader implementation in a cluster RCT.
Biography
| Original language | English |
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| Publication status | Unpublished - 2025 |
| Event | 19th World Congress of the European Association for Palliative Care - Duration: 29 May 2025 → 31 May 2025 |
Conference
| Conference | 19th World Congress of the European Association for Palliative Care |
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| Period | 29/05/25 → 31/05/25 |