bluuebunny/crossref_metadata_2025_split huggingface dataset:
A review of translation and interpretation services provided by children's hospices in the UK, March
Authors: Gandhi-Rhodes Kalyani 
Published: September 2011

IntroductionThe review was commissioned by the Children's Hospices UK Diversity Reference Group to take forward the work of the Diversity Toolkit (2009) that was developed in collaboration with Help the Hospices.The purpose of the review was to provide data on provision of Translation and Interpretation services (T.I.S) by children's hospice services and indicate what actions are needed to improve future services. The central aim was to gather views from children's hospice staff and diverse service user families. This would influence the provision and development of existing and future services to diverse communities.The findings would provide recommendations that could be adopted by Children's Hospices UK in supporting member hospices in further developing their T.I.S provision.MethodsThe review was carried out to include the provision of T.I.S services by all 44 children hospices in the UK. The review collected data by three principal means: an electronic survey questionnaire, telephone interviews and focus groups.FindingsThe review identified some significant gaps in the provision of T.I.S services but also identified a great deal of good practice to incorporate into policy and guidance that can inform the development of locally appropriate provision. The findings stress the need for language and communication support provision to be an integral tool when conveying information between staff and families.ConclusionThe findings describe significant barriers that deter access to services as well as compromise the quality of care and support provided to families using services. The recommendations seek to address the challenges by enabling children's hospices to review their existing policy and provision and develop a range of mechanisms that will provide localised support to a diverse range of families.
Collaboration in education to meet the QIPP agenda: an innovative consortium approach
Authors: Walford Carole , Hewitt Carole , Gibbons Liz 
Published: September 2011

In early 2011 three established hospices in the South West went beyond the rhetoric. They agreed to work in formal collaboration to address the education needs of their own, and external, clinical and non-clinical staff. A discussion paper was written drawing from the literature of both industry and education. A meeting of key stakeholders in March 2011 agreed a 6–12 month lead in time to the formation of an education consortium.Aim▶To establish a gold standard for equitable and transferrable EOLC education for clinical and non-clinical staff▶To meet the QIPP agenda with economies of scale▶To remove the element of competition and enable a united approach to future income generation.Method▶Initial honest transparent discussion to consider four functional areas of the consortium: ownership, leadership, membership and partnership▶This informed the governance structure and roles and functions of the staff▶A letter of intent was signed by each stakeholder organisation▶It was agreed that the consortium would be seen as part of each organisation and not an external entity▶A work plan was agreed.The mapping process has begun to look at resources in each stakeholder organisation: business development expertise, IT resources and systems, human resources and their capacity as well as the existing education programmes and their current delivery format.The work of the consortium is in its infancy. In all senses it is a learning organisation as we explore this new approach to sustainable delivery of appropriate End of Life education. The outcome and discussion will be rich by September 2011 and will focus on both the joys and challenges of this work.
Enterprise initiatives: to boldly go…….
Authors: Nickinson Caroline , Walford Carole 
Published: September 2011

The role of enterprise in the charity sector is increasingly that of entrepreneur. As the down turn in the economic climate reached the high street so did the realisation that traditional routes of income generation could no longer sustain current patient care provision, nor give scope for future planning and direction.It was agreed that this was not purely a challenge to the enterprise and income generation team. As an organisation we needed to prioritised time to work together to find fresh ground for innovative and creative income generating opportunities.An enterprise committee was set up to report to the Board. This is chaired by Chairman of the Trust and consists of Trustees, Fundraising and Retail Directors and income generation staff. The outcome from this united approach is still unfolding.Key new ideas that the income generation team have taken forward to date include:▶Sourcing sponsorship for our web pages▶A sponsored DVD about the hospice running in our charity shops▶Local businesses being approached to include us on their on- line sales as a charity of choice for their customers at a suggested donation of £1 per transaction.▶Major investment of time to sell items on Ebay.A further outcome from this work is a series of dedicated ‘blue sky’ thinking events. Benefits have included a further integration of the various work strands in the organisation and sense of unity as we “boldly go…….” into the forecasted austerity ahead.This paper will give an honest presentation of the challenges we have faced and share some of the successes and lessons learned along this journey.
Evaluating an adapted mindfulness meditation course for use in palliative care setting
Authors: Baines Elizabeth 
Published: September 2011

IntroductionMindfulness Meditation involves paying attention to our mind and body moment by moment, being aware of what arises without judgement.Experience and evaluation demonstrated that some patients receiving one to one mindfulness meditation failed to achieve their identified goals due to difficulty in committing to regular meditation practice when at home. They felt the traditional framework of the 8 week course would be to onerous.AimTo ascertain patient / carer experiences of attending a 4 week course of 1 h structured, group mindfulness meditation sessions.MethodPatients and their carers referred for meditation practice were invited to attend four 1 h weekly structured group mindfulness meditation sessions. Each attendee was requested to complete a Measure Yourself Concerns and Wellbeing questionnaire prior to first attendance and again following the final session.Results2 groups, each consisting of 3 patients and their carers attended. Regular attendance and goals were achieved, as was regular and committed practice at home. They valued the mutual support from other attendees, the positive sharing of experiences – including the challenges of practice.DiscussionThe results demonstrate that the 4 session course fulfilled patient identified outcomes and was felt by attendees not to be too onerous.ConclusionRunning a course over a number of weeks which requires regular attendance by patients can be a challenge in palliative care settings. My experience suggests that it is possible to cover the essence of Mindfulness Meditation in 4 sessions.Future studies could compare outcomes of an 8 week and 4 week course.Future practice could consider: introductory Mindfulness Meditation days; and regular meditation drop-in sessions to support regular home practice.Knowing of sessions for patients enhances staff awareness and interest in the process of Mindfulness Meditation.
e- ELCA, from the beginning
Authors: Owens Sarah 
Published: September 2011

The purpose of the presentation is to highlight innovation in practice with regards how the end of life care for all e-learning programme was implemented and integrated within a hospice. Key concepts include the introduction of e- learning to the clinical staff as a way of learning. How then could this programme be integrated into the working day and how best to monitor the progress of that integration.The issues were around availability of facilities, such as IT equipment. The varying levels of ability of the staff using the computers, and how those who were less confident could be supported. The ability of staff being released from clinical practice to complete sessions, and which of the sessions available were the most pertinent to each staff group.Staff were introduced to the programme and its concepts. Extra IT equipment was ordered with two rooms being made into e-learning suites. While this was occuring i accessed the modules and mapped out which modules each staff group would be required to complete. This would ensure that staff completed modules which were most pertinent to their role. Each staff member was given their own folders and workbooks, with step by step guidance of how to negotiate the site. Managers allocated specific time away from the clinical environment and time was spent with staff who felt less confident with e-learning as a way of learning.Staff continue to learn on a rolling programme, and some have completed all of the necessary modules. Staff report that they find this way of learning flexible and are able to utilise the knowledge back in practice. That they value the time away from clinical practice and the relevance of the topic areas to the delivery palliative and end of life care.
The multiprofessional toolkit – improving communication about patient choices for care
Authors: Tapley Michael , Cerdeira Marcia , Cardoso Anna , Vallantine Karen 
Published: September 2011

Quality patient care and family support depends on sharing information between patients and healthcare professionals. However, the number of settings where palliative care is provided may form a barrier to effective communication.Technologically advanced countries have been developing electronic patient records to enable access to information by all healthcare providers. I.T. is expensive, relying on professionals to keep records up to date and ensure confidentiality.Our patients living with life limiting illnesses could not wait for the development of databases.A paper booklet called the Multiprofessional Toolkit was designed so that patients take ownership of their health information. They ask any healthcare workers they meet to make entries in their booklet to keep it up to date. It enables problems to be managed according to the patient's wishes.MethodologyA coordinator interviewed patients and professionals from the hospice, the hospital, the primary care trust and macmillan nurses. The pilot survey guided the design of the booklet, its content and user friendly design.ResultsThe coordinator developed the toolkit. This formed a patient held record, which as a communication tool helps staff dicuss life limiting illnesses with patients and families. Patients relate the story of their illness and record it in their toolkit, reassured that professionals may understand more clearly what their priorities of care might be.It includes relevant medical information. Patients find this makes consultations easier as information does not have to be remembered burt simply read from the toolkit. Patients record changes in their views whenever they wish.Samples of the toolkit were distributed among user groups, with a feedback questionnaire. Data collected demonstrated approval for the project.It has now been printed and staff training undertaken.ConclusionsAudit demonstrated very quickly, cheaply and effectively improved communication. It could be adapted for other countries too.
Developing an end of life care community forum
Authors: Haywood Chris , Littlewood Clare 
Published: September 2011

IntroductionEmbedding end of life care in nursing homes is not sustainable on education packages alone. Evidence shows us that ongoing clinical support needs to be provided if change is to be sustained. The development of a dedicated End of Life Care Community Forum was felt to be a model that could address this issue.Aims▶To enable networking and opportunity for care homes to meet for support with end of life care issues▶To improve end of life care delivery in care homes and assist people to die in the place of their choice reducing hospital admissions at the end of life▶To establish End of Life Care Champions.Methods▶Scoping exercise▶Senior staff at the Hospice Chair and co-ordinate meetings▶Engagement with Advance Care Planning Teams (Community)▶Funding at Network Level to support roll out.Results▶Care of residents and staff morale increased▶Reduced admissions to hospital for end of life care▶Heightened awareness of End of Life Care Strategy with an increase in the use of end of life tools▶Electronic communication systems and links to 24/7 telephone advice have been enhanced.Conclusions▶Has provided opportunity for improvements in the patients pathway with shared learning between nursing home and specialist palliative care services▶Staff are empowered to utilise end of life care tools in supporting patients to die in their preferred place of care▶Requires commitment from all service providers and a level of funding from the local ICN.Recommendations▶All nursing homes providing end of life care become active members of the Forum as part of any contracts via Commissioners in line with Quality Markers▶Consider widening the remit to other service providers where end of life care is offered.
Reducing treatment dose errors with low molecular weight heparins
Authors: Campbell Colin , Coackley Alison , Thompson Anthony 
Published: September 2011

Cancer patients have a 1 in 200 risk of a venous thromboembolic event, which is five times higher than the general population. Low molecular weight heparins are used in the treatment of venous thrombo-embolism but a patient weight calculation is required to determine the correct dose. Incorrect weight estimations can lead to serious adverse effects. In general hospices do not have ways of accurately assessing patient weight.Recent guidance from the National Patient Safety Agency has specified guidelines on treatment.AimTo assess hospice compliance with recommendations from the NPSA.To initiate appropriate changes in clinical practice relating to prescribing of LMWH.MethodRetrospective audit of clinical records of patients who were on treatment for venous thrombo-embolic disease.Results▶5/6 patients with venous thrombo-embolic disease were anticoagulated▶0 patients were weighed prior to treatment▶Limited use of biochemical screening prior to treatment▶Incomplete documentation/communication to other healthcare professionals.Conclusion▶If weighing equipment not available other methods of assessing patient weight are required▶Essential information should be documented and communicated when patient care transferred to another setting▶Discussion of the pros and cons of anticoagulation should be part of routine care for all patients.▶Need for education for all hospice staff▶Review of documentation used▶Need for reaudit within 6 months.
Demonstrating quality through advanced care planning
Authors: Gallini Andrew , Reddish Melissa , Martin Tori , Barnes Steve 
Published: September 2011

The National End of Life Strategy set out a particular focus on the care planning of patients at the end of life and with one of the key 10 objectives that individual needs will be documented, reviewed and acted upon in relation to advanced care plans. Specific quality markers and measures for end of life care were published by the department of health in 2009. In relation to advanced care planning these identified a requirement that people approaching the end of life are offered a care plan and that individuals' preferences and choices, when they wish to express them, are documented and communicated to the appropriate professionals.Significant work has gone on over the past 18 months by the community specialist palliative care team at St John's Hospice to develop policy and guidance, patient documentation and information, and a dedicated database to record whether discussions around patient plans and preference have taken place. This has enabled the team to be in a position to report this as one of three key commissioning for quality and innovation (CQUINS) targets, set jointly with commissioners, which enables quality to be recognised and linked to additional funding. Results for the first full year have been very positive in demonstrating over 85% of patients have had opportunities to discuss and document their advance care plans.This presentation will explore the challenges in seeking to implement advanced care planning for patients. The need to quantify advanced care planning with patients for commissioners is a particular challenge to be meaningful, informative and transparent. The work by the community specialist team in recording a number of items related to patient preferences may be seen as a precursor to end of life registers that the team are currently involved in as part of both a local and national pilot.
Whose job is it anyway? Meeting the spiritual needs of people at the end of life
Authors: Noble Agnes 
Published: September 2011

IntroductionSpiritual care is a key element of palliative care. In the UK, NICE guidelines state that spiritual care should be offered as an integral part of care. Patients should have opportunities for their spiritual needs to be assessed and it is important for those assessing need to be highly attuned to the spiritual dimension of care. However, the results from the National Care of the Dying Audit (Round 2) in the UK show that this spiritual need is still not being met. Spiritual needs can be more urgent at the end of life.AimThe aim of this study was to explore oncology nurses' understanding of spirituality, in anticipation of a greater understanding of this elusive area.MethodUsing a qualitative cross-sectional design, inspired by a grounded theory approach, a non-probability purposive sample of seven nursing staff took part in a focus group and individual semi-structured interviews. The participants varied in age, grade and years of oncology experience.ResultsThe main findings showed the majority of nurses cited lack of time and not knowing what to say as significant barriers to giving spiritual care. The emotional impact on the nurse providing spiritual care was also identified as a burden, causing stress and feelings of inadequacy. Lack of education and training produced fear and anxiety. However, spiritual care was seen as a collective responsibility. The nurses wished to raise spiritual awareness and to deepen their own awareness in this important area.ConclusionResults suggest that despite the recognition of the importance of care in this area, nurses find difficulty in providing spiritual care to patients. Recommendations arising from the study include an education programme for nurses to increase the skills and confidence in undertaking spiritual assessment and enabling them to provide spiritual care.
Systematic review: to what extent are end-of-life patient medical treatment preferences respected?
Authors: Satherley Philip 
Published: September 2011

BackgroundEnd-of-life medical treatment preference tools are documents for guiding end-of-life practice and are commonly known as Advance Decisions, advance directives or living wills. To date, most published research on these tools has focused on their uptake and how they are understood by the general public and healthcare professionals. Less research has been published which examines whether such tools have been acted upon and the patient has received the level of care they requested.Review questionIn response to this, a systematic review was conducted which examined to what extent are the medical treatment wishes laid out in preference tools respected? Out of approximately 3500 references located, eight were included in the final systematic review.FindingsAll studies were from the USA and, as a body of evidence, indicated that the tools worked at ensuring patients' documented wishes were acted upon. These studies also demonstrated that the success of preference tools is as much about the context of care, sophistication of care models and buy-in from staff as the tool itself. Crucially, in all studies, patients' treatment wishes are recorded in an appropriate system. Implications for practice Based on the findings of the systematic review I will make suggestions for changes in the organisation of Advance Decisions in the UK and where further research is needed. Given proposed changes to the organisation of the NHS, and the increasing emphasis on patients being able to die in the place of their choice, systematic and cultural changes are needed to ensure wishes expressed in Advance Decisions can be respected whether a patient dies in hospice, at home, or in a hospital and how they are managed between settings.
Is a triage system of referrals to a community palliative care nurse specialist team workable?
Authors: Coldicott Roz , Campbell Mary , Rowlands Sue 
Published: September 2011

AimTo provide an insight into the workability of a triage system for patient referrals to a team of Community Palliative Care Clinical Nurse Specialists (CPCT).BackgroundThe community team were concerned about delays in responding to patients referred to their service. Patients are referred to a specialist service for specialist advice for complex symptom management / psychological support. Any delay in responding to the referral impedes the management of their symptoms or support and can lead to further distress.MethodsTriage was introduced as a 6 month pilot in an attempt to improve the response time in line with local and national initiatives. An audit was then carried out using questionnaires to district nurses, GPs, and the CPCT with the aim of providing the team with evidence of the feasibility of triage as a long term working commitment.ResultsTriage has provided the team with a workable practice which enables prompt response to both the patient and the referrer. Due to the process of triage the team has also ensured an accurate recording of the number of referrals, as well as a uniformed and structured response. Triage also allows for; The gathering of detailed information, by a CNS, on day of referral and provides an outcome for speed of response. Same day assessment and treatment of symptoms and if necessary referral to other disciplines, Education for referrers, patients and carers about symptom control, Provides patients and carers with telephone numbers straight away for them to access our service and 24 h helpline.ConclusionTriage is a team initiative which has directly benefited patients and carers; opened communication with referrers; ensured we achieve local and national standards; standardised the referral process; improved data collection; provided a tool for audit.