bluuebunny/crossref_metadata_2025_split huggingface dataset:
SIMPLE SKILLS SECRETS: A VISUAL MODEL OF CORE COMMUNICATION SKILLS FOR GENERIC STAFF
Authors: Groves Karen , Jack Barbara , Baldry Cath , O'Brien Mary , Marley Kate , Whelan Alison , Kirton Jenny 
Published: February 2014

BackgroundEvery healthcare worker, of any grade or role, can be faced with situations they find difficult to handle, particularly in end of life situations. Rolling out communication skills training to large numbers of people is a challenge. The ‘Simple Skills Secrets’ model was developed to provide an easily remembered visual model for any staff member, in any setting or situation where faced with unanswerable questions or lost for words. The model distils the essence of safely responding to cues, listening, encouraging, summarizing and assisting the formulation of the patient's own plan whilst resisting the urge to rush in with solutions.AimsTo assess the impact of a ‘Simple Skills Secrets’ model of communication skills training on staff confidence and willingness.MethodA mixed methods evaluation of impact on staff who had undertaken training included pre and post course assessment of confidence and willingness for 149, and qualitative interviews of fourteen, 6–8 weeks post course, using a purposive sampling approach.ResultsStatistically significant improvement in both willingness and confidence for all categories and staff of all grades. (Overall confidence score, t(148)=–15.607, p=<0.05; overall willingness score t(148)=–10.878, p=<0.05). Greatest confidence change was in communicating with carers (pre course mean 6.171; post course mean 8.171). The value of the model in clinical practice was reported and several themes emerged from the qualitative data including: a method of communicating differently, a structured approach, an easy to remember visual model, thinking differently, increased confidence, using small amounts of time effectively, gaining additional skills and helping the person come up with answers themselves.ConclusionsThis model appears to be easily remembered, increase staff confidence and willingness to engage which may result in earlier, shorter, interventions, minimizing distress, improving patient and carer satisfaction.
SOCIAL MEDIA AND PALLIATIVE MEDICINE: A TWO YEAR ANALYSIS OF GLOBAL TWITTER DATA
Authors: Nwosu Amara , Debattista Maria , Rooney Claire , Mason Stephen 
Published: February 2014

BackgroundSocial media involves the use of technological applications to facilitate the exchange of information in a virtual environment. Social media use is increasing in both professional and social contexts. Twitter© is an online social networking service and micro-blogging service that enables its users to send and read text-based messages of up to 140 characters, known as ‘tweets’. Twitter© users can prefix a keyword with a hashtag (#) allowing users to ‘tag’ the message to a particular subject of interest. Social media is used by some palliative care organisations to raise awareness and provide information. However, the degree and scope of the current use of social media to discuss palliative care issues has not previously been reported.AimsTo determine the frequency, sentiment and trend of ‘tweets’ containing palliative care related hashtags and/or phrases.MethodsA retrospective analysis of Twitter© of all tweets sent on Twitter© between August 2011 and August 2013, using a social media web analytics tool:TopsyPro©.FindingsA total of 683.5K tweets containing a combination of 13 palliative care terms were sent on Twitter. The tweet volume has increased by 62.3% annually (262.5K in 2012 versus 421K in 2013). The most popular terms include end-of-life (210K), #hpm (114K) and ‘palliative care’ (93.8K). Sentiment was high with 89% of tweets terms more positive than all other tweets sent in this period. The term ‘Liverpool Care Pathway’ experienced the highest percentage increase in tweets (55% increase) reaching a peak in July 2013.ConclusionsA lot of discussion about palliative care is currently taking place on Twitter©, and the majority of this dialogue is positive. Social media presents an opportunity engage with the public and professional groups; further work is needed to determine how this can be effectively coordinated.
WHAT TRAINING DO I GET ON THE LIVERPOOL CARE PATHWAY?
Authors: Srivastava Leena , Ting Ruth ,   Members of LCP working group
Published: February 2014

BackgroundIn July 2013 an Independent Review of the Liverpool Care Pathway (LCP) recommended that it should be phased out and replaced by an individual end of life care plan. The review emphasised the need for robust education for clinicians involved in caring for dying patients. It is therefore crucial we understand how staff review the education they receive on the LCP.AimTo evaluate clinical staff's views on education they receive on the LCP.MethodTwo wards in Gateshead Health NHS Foundation Trust were randomly chosen. In June 2013, all their staff were invited to complete an anonymous survey. Currently, end of life training is not mandatory and staff access education as per their needs.ResultsCurrent training47% of clinical staff responded. 31% were confident they had received training on using the LCP. 46% of respondents felt they were confident in using the LCP.Future Training51% of respondents felt that the LCP should be part of mandatory training. 63% would access further training if available.LimitationsOur results are based on less than 50% response to the survey and may therefore not represent the full views of all staff.DiscussionOur survey shows that the majority of staff are not confident in the use of the LCP. This may reflect lack of training but also lack of clarity around what education staff may need for caring for dying patients.In contrast, clinical staff are clearly keen to improve their knowledge and feel a need for mandatory end of life training.ConclusionThis survey has shown that clinicians perceive a lack of education around the use of the LCP. This will need to be addressed in order to build a confident and competent end of life care workforce.
‘DINING WITH DEATH’ – CONVERSATION MENUS AS A MEANS OF EDUCATING PEOPLE ABOUT DEATH, DYING AND BEREAVEMENT
Authors: Patterson Rebecca , Hazelwood Mark 
Published: February 2014

There is growing consensus that palliative care encompasses a ‘health promoting’ element concerned with encouraging openness about death in society so that people are aware of ways to live and support each other with death, dying and bereavement. A general societal reluctance to engage with these issues makes it harder for clinicians to initiate timely discussions with patients about their end of life care wishes.However, finding ways to educate wider society in issues relating to death and dying can be problematic in a culture where raising these issues is variously perceived as too morbid, too difficult or too sensitive to mention.This poster describes theDining with Deathmenu and some of the settings in which it has been used, exploring its potential as an experiential learning tool to enable people to become more open about discussing death and dying.TheDining with Deathconversation menu is a folded piece of A4 card, printed with three ‘courses’ of suggested conversation topics, for example ‘Cremation or burial?’; and ‘What would be in your death plan?’.The menu was first used November 2011, with 60 individuals from various organisations, who had been invited to a restaurant lunch to mark the launch ofGood Life, Good Death, Good Grief.Since then,Dining with Deathhas been used to facilitate discussions at education events for health professionals and two ‘death cafes’ atJust Festival.These events indicate the menu has potential as a learning tool: it can be used flexibly, across different types of events and different audiences; it overcomes barriers to engagement in death discussions by intriguing participants and engaging them in non-threatening conversations through which they can learn from their own and others' experience. There is potential for further evaluation and development of theDining with Deathmenu in the future.
SYMPTOM UPDATE BOARDS—DELIVERING EDUCATION AT THE FRONTLINE
Authors: Poultney Jo , Maclaren Sarah , Raper Jude , Johnson Helen , Tallon Carole 
Published: February 2014

BackgroundEnsuring that we all deliver the best possible care requires continued learning and updating of our skills and knowledge. The challenge for all healthcare professionals is balancing the need to be on the frontline delivering care with the need for professional development. Myton Hospice recognised that an additional approach for education was needed to increase the opportunity for learning and so the symptom update boards were devised.AimOne of the five commonest symptoms experienced by patients at the hospice was allocated to a senior clinician and they were asked to produce a board (24 inch by 32 inch) by using a variety of coloured marker pens to cover what they felt were the most important learning points about that symptom. All the information was based on the West Midland Palliative Care Physicians Guidelines to ensure we had consensus of opinion. A baseline assessment of knowledge was carried out. Each board was then placed in a prominent position at one of two inpatient units or three day hospices. The boards were accompanied by a question sheet to support their learning. Each board was kept in place for one month and then rotated round to a different unit.ResultsThe boards have been very well received by all of the nursing staff in the different units. The nurses have commented they are able to find some time during the working day to absorb some of the information given or they pick up facts even whilst carrying out their day to day work just by glancing at the board from time to time.ConclusionBased on the enthusiasm for the boards we hope to continue developing this education tool further but await results of our assessment to determine if they have had a sustainable impact on knowledge around symptom management and if this translates into an improvement in patient care.
PROLIFIC USE OF MISLEADING ABBREVIATIONS BY HOSPICE HEALTHCARE PROFESSIONALS
Authors: Bell Sarah 
Published: February 2014

BackgroundThe use of abbreviations is widespread amongst healthcare professionals, despite studies showing they can be misleading and lead to medical errors. For example, SCC is used for both spinal cord compression and squamous cell carcinoma. Junior hospice staff often come from a generalist background and may interpret abbreviations as having different meanings from those intended.MethodIn order to evaluate the use of abbreviations at one hospice, a list of abbreviations were approved as being in standard use. The multidisciplinary notes from ten admissions were audited for non-approved abbreviations. Using the results of the initial audit, the approved list of abbreviations was revised and a limited duration hospice education programme was undertaken. A year later a further audit of abbreviation use in the notes was undertaken.ResultsThe initial audit found that 108 different, non-approved abbreviations were used on 735 occasions. Several abbreviations had more than one meaning, and the intended use and meaning varied significantly between individuals and disciplines. Disappointingly the re-audit showed only a 14% reduction in the use of non-approved abbreviations. This appeared to be particularly associated with junior doctors in short term posts.ConclusionThe use of potentially unsafe and misleading abbreviations is a prevalent and entrenched practice in hospice staff. Due to high junior doctor turnover, hospices need to develop rolling educations programmes to reach temporary as well as permanent staff.
CAN JUNIOR DOCTORS LEARN ABOUT PAIN MANAGEMENT THROUGH E-LEARNING?
Authors: Srivastava Leena , Lee Mark 
Published: February 2014

BackgroundThe management of serious life limiting illnesses spans across all specialities in medicine. One of the crucial goals for both patients and professionals is the effective management of pain. It is therefore vital for all doctors to have an insight into the basics of pain management.E-learning is an innovative way of teaching. It provides flexible access to learning which can be used to target a wide range of doctors.AimTo evaluate the effectiveness of e-learning in improving the pain knowledge of Foundation 1 doctors.MethodFoundation 1 doctors in Sunderland Royal Hospital were recruited in August 2010 at their induction programme. An e-learning module was constructed based on their curriculum and regional guidelines. The module started in November 2010 for 1 month. Pre and post module questionnaires as well as evaluation forms were completed by learners.Results14 foundation doctors initially agreed to participate in the module. 36% completed the course. The mean pre-module score was 62% (95% Confidence interval 53–70%). The mean post-module score was 77% (95% confidence interval 67–86%, P=0.042). There was also a mean improvement of 1.0 point on the Likert scale evaluating confidence in pain management.DiscussionOur results have shown that an e-learning module on pain specifically targeted to foundation doctors can improve both confidence in different areas of pain management as well knowledge. There was however a high attrition rate at 64% despite regular contact. The motivation of learners and their inherent interest may account for this.LimitationsQuestions in the pre and post module questionnaires have not been formally validated.ConclusionThis study has shown that it is possible to improve the pain knowledge of foundation doctors through an e-learning package. Barriers in accessing e-learning need to be evaluated to target a wider range of doctors.
‘BEING WITH YOU’. EVALUATION OF A NOVEL ‘VOLUNTEER COMPANIONSHIP TRAINING PROGRAMME’ FOR SUPPORTING END-OF-LIFE CARE WITHIN AN ACUTE HOSPITAL SETTING
Authors: Mayland Catriona , Gent Miriam , Raj Julie 
Published: February 2014

BackgroundAlthough the value of hospice volunteers is widely recognised, their role within the hospital setting is less established. An end-of-life volunteer companionship programme was established within an UK hospital to help support dying patients and their families (provision of ‘sitting’ service and psychological support).AimTo assess the effectiveness of a two-day volunteer training programme.MethodsFifteen hospital volunteers were recruited due to length and experience of service; a further two through personal expressions of interest. A questionnaire (assessing knowledge, confidence about communication and support skills) was given: pre-training; 2 weeks post-training; and 3 months post-training. Each question (n=17) had 5-point Likert-scale response options (1=strongly disagree, 5=strongly agree). Free text response boxes were provided.Two further cohorts of volunteers have been recruited (total n=30) and additional results are forth-coming.ResultsFrom the initial 17 volunteers, 14 were female with ages ranging from 19–70 years. Statistically significant improvements were seen across all knowledge scores post-training and were sustained after 3 months.Volunteers were confident about their communication skills, with all question items (bar one) having initial mean scores of >= 4.38. Their responses showed least confidence in their ability to answer ‘difficult’ questions (mean score 3.94). Although all scores improved post-training, none showed statistical significance.Volunteers were confident in their abilities to support families (baseline mean score 4.31). For all other support skills, post-training all question items showed statistically significant improvements. Except for spiritual support, confidence levels were sustained at 3 months.Free-text comments supported the value of the training programme for their work with dying patients and their families.ConclusionsWith careful selection process, a short training programme covering pertinent end-of-life care issues is effective in providing volunteers end-of-life care knowledge and skills.
LESSONS FROM FOUR COUNTRIES IN SUB-SAHARAN AFRICA IN DEFINING AND DEVELOPING INTEGRATED MODELS OF PALLIATIVE CARE
Authors: Downing Julia , Leng Mhoira , Namukwaya Elizabeth , Murray Scott , Atieno Mackuline , Grant Liz 
Published: February 2014

BackgroundThe THET (Tropical Health & Education Trust) partnership project onStrengthening and integrating Palliative Care into national health systemscommenced in 2012. The project aims at enhancing the provision of palliative care in Kenya, Rwanda, Uganda and Zambia through the integration of palliative care into existing services within 12 hospitals and their associated community hubs.AimsAn important component of the programme was to capture the evolution of the models of integrated palliative care developed in each of the 12 hospitals.MethodsWe conducted a baseline assessment, ongoing review and dialogue with regards to the vision for palliative care service provision to help map the process. For each hospital a matrix was developed which built on the core internationally accepted components of a model of care e.g. staffing, setting, services provided, types of patients seen, referral process, management of patients, integration within the health systems etc.ResultsThe process of defining and developing a model of care was unique for each setting, and was fluid and constantly changing. Different hospitals were able to articulate different components of the model at different stages, for example, some hospitals have clear visions for palliative care but are uncertain about options and best methods of implementing their visions. An important component of the model was mapping of the referral networks, which was challenging.ConclusionThe process of defining and developing a model of integrated palliative care go hand in hand, changing over time. Defining a model is challenging, but integral to the development of that service. Support is needed to services to do this, and the model will evolve over time. Strengthening this process and providing evidenced based frameworks from similar settings showing health systems integration is an important means of support. Many lessons from Africa are relevant to more economically developed countries.
THE EVOLUTION OF CARING FOR DYING PATIENTS IN INTENSIVE CARE UNITS IN THE UNITED STATES FROM 1960–1980
Authors: Kongsuwan Waraporn , Keller Kathryn , Chase Susan 
Published: February 2014

IntroductionSince Intensive Care Units (ICUs) appeared in the United States in the late 1950's, nurses working in them have always cared for the dying patients. A historical reflection of the evolution of caring for dying patients in ICUs would assist in care model development. To discover retrospectively how and why caring for dying patients in the ICUs has changed can support ICU nurses in the present in developing their future care of the dying.PurposeTo examine the evolution of caring for dying patients in intensive care units in the United States from 1960–1980.MethodsHistorical research method was used in this study. Data were obtained from primary and secondary sources, including electronic databases, critical care journals, and text books. Three intensive care nurses who practiced within the timeframe participated in the oral history interviews. The data were analyzed by using content analysis. Validity and reliability were established.FindingsThe three major themes that emerged were: lack of formal preparation for care of the dying (1960–1980); increased workload and stress (1970–1980); and becoming more concerned about quality of end-of-life care (mid 1970s–1980).ConclusionNurses and healthcare professionals in the United States and worldwide could use this knowledge as a source to compare and develop their future practices in care for dying patients in the intensive care units.
LIVED EXPERIENCE OF CANCER PATIENTS AND THEIR FAMILY MEMBERS IN A VIEW TO DEVELOP A PALLIATIVE CARE GUIDELINE FOR THE NURSING PERSONNEL
Authors: Savio Anu , Priyalatha A 
Published: February 2014

Alleviating the problems faced by patients in their advanced stages of cancer and their families has drawn substantial public attention, but little is known about the experience of these people.Objectives of the studyTo elicit the lived experience of cancer patientsTo elicit the lived experience of their family members.To identify the needs of cancer patients and family members for developing a palliative care guideline for the nursing personnel.MethodsA phenomenological approach using descriptive analysis was utilized to explore the human experience of the phenomena under scrutiny. Interviews were recorded and verbatim were transcribed, and they were manually analysed. The Colaizzi methodological approach was used.ResultsThe 10 themes identified for the cancer patients were: all change, feeling of helplessness and hopelessness, uncertainty, wishing to fulfil their role, accepting loss of control, feeling of becoming a burden, fear of death and loss, desire to live, wish to be with dear ones, developing trust in god's plan. The essence of the phenomenon, experience of living with cancer, was to regain a control over the existential changes i.e. the situation and one's own body. The 6 themes identified for the family members of the cancer patients were questioning god, living with fears and uncertainty, issues related to happiness, feeling of added responsibility, ensuring best possible treatment and care and confronting negative feelings. These six themes gave a structure presenting the essence: balancing a changed life situation in fear and uncertainty.ConclusionThe results of this study challenge nurses to be conscious of the nature and difficulties that not only patients face but also family members are encountering. The study can increase the understanding of what it is like to have cancer in its advanced stage.
SHORT-CAM – A USEFUL DELIRIUM SCREENING TOOL IN PALLIATIVE CARE?
Authors: Porteous Anna , Lowery Lucy , MacCormick Fiona , Paxton Ann , Vidrine Jennifer 
Published: February 2014

BackgroundThe short-CAM (Confusion Assessment Method) delirium screening tool is validated in the palliative care setting. As an observational tool it is felt to be acceptable in its ease of use, however, some studies highlight challenges in its implementation.Delirium screening using the short-CAM has been incorporated into routine assessment in five North East Specialist Palliative Care In-patient Units (SPCUs).AimsTo assess staff opinion on the importance of screening for deliriumTo determine the acceptability of the short-CAM as a screening tool.MethodsPatients admitted to five SPCUs were regularly screened for delirium using the short-CAM. Clinical and allied health professionals participated in multi-disciplinary assessment of patients to inform short-CAM completion.After four months of use, a voluntary and anonymous survey of staff members was conducted. Verbal rating scales were used to record staff experiences of the tool's implementation, their impression of its value and ease of use.ResultsSixty-three doctors, nurses, allied health professionals and administrators completed the survey.Fifty (79%) respondents believed screening for delirium to be important, however, 62% of those involved in using the short-CAM felt it did not always accurately reflect patients' condition.Sixty-four percent of staff members found the short-CAM “not at all” burdensome to complete, however, only 44% felt the short-CAM should be introduced into routine care. Ten percent of respondents did not feel it should be introduced and 46% were unsure.LimitationsCompletion was voluntary and time limited, creating potential bias in responders.ConclusionsThe majority of health professionals believe screening for delirium to be important in the palliative care setting, however less than half believe the short-CAM should be introduced into routine patient assessment. This is likely to be multi-factorial, relating to paper-work burden, limited perceived impact on patient care and lack of confidence in this tool to reflect a complex patient group.