bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food for thought!
Authors: Bacon Ruth 
Published: September 2011

IntroductionThe hospice recognised the importance of good nutrition for palliative care patients but there was a lack of research in relation to their nutritional needs. As a result, in 2008, it established a nutritional working party.Aims▶Increase the diet and nutritional needs knowledge of clinical staff▶Improve recording of individual dietary needs▶Give patients permission to eat what they choose and develop the food choices available to them▶Review of the availability and benefit of nutritional supplements▶Improved the quality of nutritional advice across all departments.MethodTo form a multi professional group who has representation from the nursing and medical teams, community dietician, catering department and volunteers. The group meets at 6 weekly intervals and its purpose is to:▶Educate all staff members on the provision of nutritional care for patients with life limiting illness▶Create new initiatives to enhance the provision of nutritional care▶Develop more collaborative working with multi professionals in nutritional care.ResultsThe group has initiated:▶Nutritional theme weeks▶Alcoholic drinks menu▶Increased variety of food choices▶Education board and resources folder▶Training sessions in relation to food choices and appropriate nutritional supplements.ConclusionThere has been positive verbal feedback from staff members and service users. The working group has demonstrated excellent collaborative working leading to a greater understanding of nutritional care and has highlighted the need for future innovations, such as nutritional competencies, and the development of nutritional assessments.The hospice is participating in the Help the Hospices patient survey the results of which will inform this work. It has also participated in a Help the Hospices pilot to develop a nutritional assessment tool.
Improving psychosocial care: the way forward
Authors: Clarke Karen , Wass Tricia 
Published: September 2011

IntroductionA review identified the need to:▶Create a strategy for delivering psychosocial care▶Develop psychosocial skills▶Provide counselling.AimUndertake a pilot to▶Allow time and give value to the psychological well-being of patients/families▶Enable staff to recognise emotional distress and empower them to act upon it▶Enable difficult conversations to be handled confidently and sensitively.Method▶Recruited six, part time counsellors▶Reflective sessions to share experiences▶Introduction of 10 Psychosocial Care Champions▶Questionnaire to establish a baseline▶Training in providing psychosocial care▶Clinical supervision – supervisor and supervisee training, developing documentation▶Innovative training of volunteers and non-clinical staff in psychosocial skills.Results▶Psychosocial Champions – encourage informal, regular conversations about psychosocial needs▶Counsellors provided a safe space to express and explore patients' sense of loss▶“Hospice brand” brought familiarity enabling counsellors to develop therapeutic relationships in short timeframe▶Questionnaire (42% response) revealed:▶Time and capacity – an ongoing challenge▶Respondents were able to:▶Identify psychological/social needs and own limitations▶Develop trusting, non-judgemental relationships with patients/carers.Discussion▶Insufficient capacity to improve psychosocial data – next phase▶Questionnaire will be repeated to assess the progress made.ConclusionThis pilot phase has identified the need to have a full time resource driving psychosocial care who will:▶Ensure specialist and general psychosocial support for patients/families is available at all times▶Continue to develop the MDT▶Create a culture where people feel confident to try new skills▶Ongoing training and development▶Develop a tool kit based on the findings from the questionnaire▶Maintain the integration of bereavement services▶Increase external liaison with other services▶Explore the possibility of income generation.
Reaching out to schools: a vocational experience programme for school students
Authors: Stocks Susan 
Published: September 2011

IntroductionTraditionally, the hospice has offered vocational placements to students over the age of 16 who are undergoing health and social care training at College or University. There had been many requests from schools for placements for the under 16's who have a ‘work experience’ week as part of their Year 10 studies.AimTo work with local secondary schools to enable their students (aged 15) to participate in worthwhile and productive vocational experience within the hospice.MethodStudents who choose vocational experience within the hospice are invited with their parents to discuss the work of the hospice, have a tour and discuss a programme for the week.Following the meeting an information pack is sent to the student which includes objectives, the programme, and information around confidentiality.A typical programme would include:▶Working on the In patient unit, and with Hospice @ Home▶Working in Day Therapy, attending breathing clinics and joining in activities, such as art therapy▶Observing the complementary therapists▶Meeting with a Counsellor and the Chaplain.On day one there is an induction with a Mentor who the student will meet with each day to discuss their learning experience.On completion of the placement, Evaluation forms are completed by the student and the organisation, and a Certificate of Attendance and Achievement issued.ResultsVery positive feedback has been received from the schools, students and hospice staff and volunteers, with students showing an increased interest in volunteering.ConclusionThis new programme has:▶Raised the profile of the hospice within the local school community▶Led the hospice to reflect on the lower age limit for volunteering▶Enabled the hospice to make further links with schools in relation to the curriculum.
Nursing workforce modelling in UK hospices – recommendations for future planning
Authors: Roberts Dai , Hurst Keith 
Published: September 2011

ContextUnited Kingdom (UK) hospice ward staffing has remained unchallenged for two decades while specialist palliative care provision has changed markedly, bringing new workforce demands. Yet, there has been little evidence to inform hospice workforce structures, which aspire to deliver the highest quality holistic care to specialist palliative care patients and their carers. Workforce planning and development has been described as ensuring that sufficient (but not over-sufficient) and appropriately qualified staff are available, in the right place and at the right time to match service demand. Key elements that influence nurse staffing levels include ward occupancy, patient dependency, nursing activity, workload and staff mix.MethodAn evaluation method adapted from a UK-wide nursing workforce planning and development study was used to assess nursing activity in a patient (and carer) dependency context within 13 hospices (16 wards).FindingsA dataset, which profiles and benchmarks hospice ward patient dependency, nursing workload, staff activity, ward establishments, quality and costs in 16 hospice wards has been created. There are marked differences between hospices across the UK within each of the workforce modelling elements. Hospice ward staff face heavier workloads; wards are better staffed and more expensive to run, but deliver higher-quality care than their NHS counterparts. Structural and procedural differences between hospice wards in the study are hard to explain.Conclusions and recommendationsThe hospice dataset provides evidence-based recommendations to inform specialist palliative care nursing workforce modelling, including deciding future nursing workforce size and mix based on rising workloads. The new dataset is suitable for use in all UK hospice wards.
It's good to talk: an insight into counselling
Authors: Harrison Mark 
Published: September 2011

Therapeutic movement remains valid right up to the end of life, maybe particularly so when “unfinished business” maybe hovers near. Counselling can meet and absorb the unpredictability that any client may bring to a Hospice, or any other care setting. This presentation is intended to promote the effective use of such a service in Hospices aiming to offer holistic care.An insight into Counselling is presented, to promote understanding of how a space to talk can go far beyond other supportive relationships. Counselling can provide a lot of comfort, but it is designed to offer a whole lot more. A fictionalised re-enactment is offered, based on two actual counselling sessions, showing how highly distressing material may be worked with. It should be noted that this relates to experiences that some may find difficult to discuss.The actual life experiences shared in any counselling is unpredictable. Once a relationship develops there is maybe an ethical duty to see it through even if a difficult referral might be made. In the palliative care realm specifically, there is sometimes maybe no time for a second attempt, or even a referral. For this reason, the added flexibility that person-centred counselling offers is useful here.Any counselling might be seen as an emergent research process unique to the client, the counsellor and the relationship they form, allowing the client to explore whatever they may and find their way through their difficulties.The presentation is intended to promote understanding of the space that person-centred counselling offers when facing the unpredictability there is in meeting any person in a holistic way. While this is based on an unusual and even extreme situation, the importance of being prepared to meet whatever may come is underlined.
Advance care planning documentation adopted county-wide
Authors: Chester Helen , Johnson Sally , Jones Sally 
Published: September 2011

IntroductionThe process of advance care planning is a vital and integral part of our practice. A need was identified for documentation to be developed locally to enable written records of patients' preferences and goals at the end of life which would also provide a tool for healthcare professionals.Aims▶To develop an Advance Decision and Advance Statement form with guidelines for health and social care professionals.▶To develop patient information leaflets.▶To gain service user feedback about the use of the forms.▶To subject the forms to rigorous review by the hospice clinical governance committee, PCT and hospital trust committees before launching the forms and guidelines county-wide.MethodThe draft forms were piloted for 3 months at the hospice. Feedback about ease of completion, appropriate timing of discussions and positive outcomes or problems relating to use of the forms, were collated. The forms and guidelines were then subject to review in all care settings, including trust resuscitation committees and solicitor.ResultsAll patients and staff involved in the pilot found the forms easy or very easy to complete. One patient died in his preferred place of care as a direct consequence. Most patients wished their GPs and hospital consultants to have a copy of their completed form. The forms are now progressing through the documentation committee; respective logos will then be added prior to their launch.ConclusionIntroducing the forms across all settings, accompanied by education and training, aims to raise the profile of advance care planning and improve exchange of information so that professionals in all settings are aware of a patient's documented wishes for end of life care.
Small is beautiful
Authors: Stubbs Lucinda 
Published: September 2011

Something's it's the small things….In Summer 2010 we picked up an great idea from the NCPC for ‘Small is Beautiful’ aimed to get patient and carer feedback on what small things make a difference to them. Not only did the team at St. Michael's Hospice think this was a fantastic idea but it also fitted nicely with our commitment to using feedback to guide service development and improve the way in which we work.While we felt it was important to know what our patients and families thought of the Hospice we also used it as an opportunity for staff and volunteers to feedback their thoughts.Some of our patient comments:▶Feeling cared for.▶A home from home.▶Thank you for the cake, it was yummy!▶Treating each other as special.▶Being offered some lunch during a long visit, thank you so very much.▶Thanks for the comfortable sofas!With regards to staff and volunteer feedback we have implemented many new initiatives including a rolling educational programme, a monthly staff bulletin, more social events and most importantly improved the quality of our tea bags!We ran the campaign for 6 weeks and produced Boards which were displayed in patient areas, the Hospice staff room and our seven Hospice shops. People could put their comments on the board.It was an interesting exercise for us all and provided us with a better understanding of what is important to our visitors and staff and allowed us to make some simple but necessary changes to the way in which we work. We hope to continue building on this in the future and plan to run the Small is Beautiful campaign again in April 2011 where no doubt we will receive some more interesting comments.
Learning lessons: how listening makes us more local
Authors: Ladds Martyn , Davison Steve 
Published: September 2011

At Sue Ryder we'd like to share what people told us about the way we communicate and the specialist palliative and end of life care we provide. We'd like to talk about the things people told us and the improvements we're now making.We asked what a specialist palliative and end of life care provider needs to do, to be better. After listening to what people told us, and looking at the health and social care sector, we're making visible changes in how people understand and experience our services. We'd like to share what we've learnt.The session will share research findings. Sources include: IPSOS MORI and service-users. We'll talk about how the experience of inpatient and day therapy services. We'll describe the way we're now communicating with service users, families and friends. We'll refer to case studies including the Department of Health funded capital scheme at Sue Ryder – Manorlands Hospice. We'll also share what how introducing new touch-screen technology, and the Information Standard, can help improve the quality and integrity of print and online communications.The session will cover lessons learnt, and how some assumptions were challenged. We'll show how listening is now helping us build a better future.Objectives▶Share research evidence from IPSOS MORI, NOP, and service-users▶Case study the Department of Health capital scheme at Sue Ryder- Manorlands Hospice, Yorkshire▶Describe how we're increasing local engagement and identity▶Explain how new technologies and printed information can create better user experiences and assurance▶Describe how these lessons are influencing a new state of the art hospice facility at Peterborough, in Cambridgeshire (opens 2013).
Hospice apprentice with the South Asian community
Authors: Davison Steve , Hussaine Sikander , Taylor Vanessa 
Published: September 2011

Presentation aimTo explore the implications for hospices of a 3 year DH funded project based at Sue Ryder Manorlands Hospice with the twin aims of▶Increasing the access for specialist Palliative care from the South Asian community▶Achieving the first aim by recruiting 10 unemployed people from the South Asian Community to 12 month apprenticeships with an NVQ in Health and Social care.MethodologyIt is recognised nationally that there is a very low uptake of specialist palliative care services from people from various ethnic minority backgrounds and also a significant problem in recruiting skilled healthcare staff from these same communities. Various research studied have identified the problems but little work has been undertaken to find practical solutions to engaging effectively with these communities. The project is set in an area of high deprivation and high levels of unemployment within the South Asian community.Working in partnership with the PCT and local community organisations the project takes a community development approach to recruit unemployed people from these communities into apprenticeship posts which will give them the skills and qualifications in Health and Social care. As part of their apprenticeship each student is involved in developing shared understanding, new ways of working together as well as breaking down the barriers between the South Asian community and the various statutory and voluntary sector healthcare organisations involved in palliative care.ResultsAn independent evaluation is being undertaken by the University of Bradford and the results of their interim report are used as the basis for this presentation.ConclusionThe research demonstrates a practical model which can be adapted by any hospice who wants to increase access to hard to reach communities and improve recruitment from similar groups.
Challenges in the transfer of patients from hospice to nursing home: a model for future partnership
Authors: Traxler Polly 
Published: September 2011

IntroductionTransfer of patients to nursing homes for end of life care is often difficult. Patients and carers express anxiety and feelings of abandonment during the process. At The Hospice of St Francis we reviewed 10 hospice discharges in order to plan the introduction of transitional support volunteers to regularly visit patients and carers following transfer. Data is presented from our review of 10 discharges to nursing homes.Aims▶To identify if there are predictable /repeated issues causing distress in the transfer process.▶Whether continued involvement of a ‘familiar face’ would benefit a patient/carer in the transfer process.▶To work in partnership with nursing homes to reduce transitional anxiety.MethodWe reviewed 10 discharges from The Hospice of St Francis to 5 nursing homes (Aug ‘10 – March ‘11). Focusing on timeliness, carer/relative involvement and stage of illness at transfer.ResultsThe hypothesis is:▶The greater the involvement of carer/relatives the longer the transfer process▶All of the patients/relatives expressed some level of anxiety with the process▶For some anxiety and feelings of abandonment intensified post transfer leading to a move within days to another care setting.DiscussionThe analysis of 10 discharges from the Hospice to nursing homes highlighted that both clinical and psychosocial issues contribute to transitional anxiety. Nursing home staff welcome support in addressing the psychosocial needs of people at the end of life.ConclusionHospice care should not end once a person moves to a nursing home. We should focus more on reducing feelings of abandonment/loneliness for patients/carers transferred to nursing homes. The Hospice of St Francis Hospice will pilot a ‘transitional volunteer service’ for 12 months from May 2011 to May 2012.
Keep on going: providing a flexible blended learning end of life education programme
Authors: Willoughby Janet , Watson Lois , Gittins Samantha 
Published: September 2011

IntroductionNursing home staff want to provide end of life care that will maintain their residents dignity, comfort and best interests in the familiar surroundings of the nursing home. Education and support is a key part of this. The Hospice of St Francis provided a mentor education programme to two care homes to facilitate them in this care.AimTo enable the care staff to provide excellent end of life care for their residents encompassing all six steps described in the NHS National End of Life Care Programme.MethodsHome 1 is a nursing home for people with learning difficulties, caring for their complex needs. Home 2 is a nursing home for people with dementia with multiple co-morbidities. A mentor is made available to support the staff through an end of life blended learning 6 module and follow-up workshop experience. An audit of patients notes before and after the programme plus staff confidence questionnaires enables evaluation of the programme.ResultsBoth care homes have seen an increase in their confidence and competence in care.DiscussionThis project is innovative because of the flexibility of methods in delivering the support and training. Home 1 worked methodically through the blended learning. They were keen and ready to do the work shop and currently are gathering/developing tools to underpin this process. Home 2 were enthusiastic beginners but were unable to work through the programme. Now the staff have made time over 2 days to receive group face to face training before going on to gather the tools/action plan they need to achieve the relevant national quality markers. The mentor made herself available to work alongside the care staff, supporting, enabling and challenging their practice through the relationship of trust and support.ConclusionBlended learning using a mentor approach provides a flexible learner centred education programme.
Innovative pre and post bereavement work with children: unique ways with animals
Authors: Fernandes Jo , James Alex 
Published: September 2011

AimsThrough the catalyst of ‘pony experience’ bereaved children and parents are facilitated into meaningful conversations with each other and supportive relationships with other families.MethodOnce a month bereaved children and families are invited to meet in the Hospice Woodland Walk for Pony Experience, including grooming and riding.Results▶Commonalty of experience: participants meet other bereaved families, enabling them to share “their stories” should they wish and develop co -supportive relationships.▶Children gain confidence – “Life will go on even without their loved one”▶Observing other children confirms they are not alone, seeing others having fun gives permission for them to do likewise.▶Walking side by side feels less intense, enabling easy conversation and ability to explore and chat at differing levels.▶This informal bereavement group work is well attended with positive oral feedback. Formal evaluation underway- results pending.DiscussionBenefitsChildren feel more at ease when handling a pet or when being “carried” by a pony. They can use the animal as distraction from uncomfortable conversations to disclose intimacies/memories that may otherwise be difficult.ChallengesGaining insurance for the pony component proved challenging but possible. Health and safety issues require stringency.ConclusionIntrinsic to palliative care and bereavement support is focusing upon the little things that make a person feel respected and loved. We have launched a project that is simple in its theory, but complex and diverse in its positive outcomes.RecommendationsWe appeal to all Hospices to explore whether they could use pets in similar ways to support children requiring essential but difficult pre and post bereavement care. Oral presentation will include photos (consented)and interviews from users.