bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fireworks and feelings – reaching out creatively to young people through the storm of bereavement
Authors: Gardner Dee , Sullivan Paul 
Published: September 2011

Children and young people are often shielded from the initial trauma of a terminal diagnosis of a parent or significant care giver, resulting in less time to come to terms with an imminent death than older family members. This may affect their bereavement. Fireworks and Feelings children's project encourages early, open support among peers.To enable a sharing of experiences between bereaved young people, using choice and free expression, young people were invited to attend an art day.They used creative arts as a medium for expression within a safe environment with clear expectations and a choice of artistic materials for all levels of ability; we had a shared, social lunch in the middle of the day, and they each chose one art work from the day for display in an exhibition of their works, later, continuing the sharing theme. The day was faciliated by volunteers with support and encouragement to express, with minimal instruction. The follow-up exhibition and celebration is for all participants and their families.A positive experience of peer sharing which extended beyond the day with many of the young people swapping email address and phone numbers. Keeping in touch, sharing, understanding individual grief feelings and developing peer support enhanced well being and psychological health. The Exhibition reunited this group, and shared with family and friends the celebration of the special person and their achievement of expression.Involvement in the arts assists in the development of mental and social health and well-being. It allows freedom of expression and playfulness. Young people create social and psychological bonds and relationships extending beyond the art day. There is exploration and expression of deeper levels, without words, providing an alternative method for those who may struggle to put words to the feelings around such an important and significant loss.
Sharing innovation to improve access to specialist palliative care: making a triage DVD training tool
Authors: Burrows Lesley , Toland Louise , Godfrey Sarah , Sen Michaela , Miah Yvonne 
Published: September 2011

The widening access agenda and quest to extend palliative care services to all has resulted in a significant increase in referrals for community support. Working innovatively to create flexible, accessible and responsive services to meet increasing demand, our hospice developed an enhanced telephone triage service.The telephone triage service plays an invaluable role in providing high quality specialist palliative care advice to increasing numbers of patients in the community. Audit of the clinical activity of both our community palliative care and triage services demonstrates that the addition of the telephone triage service has enabled us to deliver quality specialist support to 67% more patients in the community.The success of the service and the outcomes it achieves has attracted much interest from other providers of palliative care. Requests for information, and for facilitated visits to observe the service in action were so frequent that we decided to produce a DVD and accompanying training package to support others in establishing a similar service.A project group was formed to guide DVD production from the writing of the bid, to the marketing of the final product. The remit of the group was to work collaboratively with partners and service users to produce an informative learning tool to support others in setting up a telephone triage service.The production of the DVD and accompanying training package brought many positives, from the benefits of partnership working to demonstrate the value of services were clearly evident, to the role of education in sharing ideas and best practice. Most importantly though, the project gave us hope that in developing an educational tool to facilitate the sharing of our innovative service design, we would be playing a part – albeit a small one – in advancing rapid access to palliative care and improving outcomes for patients.
Compassionate communities: from reaching people to working in partnership with communities at EoL
Authors: Murungu Diana , Welch Daphne , Swani Tina 
Published: September 2011

IntroductionBirmingham St. Mary's Hospice (BSMH) is working to increase access to excellent EoLC services to patients and their families from minority communities in Birmingham. Through this work we are aware that communities provide support to their members at end of life and during bereavement. Communities appear to take their contribution for granted as their ‘way of life.’AimsIncrease awareness and use of palliative care services for minority communities. Increase conversations around death, dying and bereavement. Identify and work with compassionate communities to support patients and families in the community through partnership working with clinicians. Create a forum for sharing care ideas between communities and service providers.Methods▶Qualitative methods: Purposive and snowballing sampling. Education for clinicians at the hospice.▶'Sharing Care' Conference.ResultsCompassionate communities exist in Birmingham who support their own members at end of life. They are willing to work in partnership with clinicians to support patients. A Reference group made up of community members has been set up at the Hospice. Community leaders participate in our training programme for clinicians to raise awareness of how culture and spirituality can impact on access to services.Discussion pointsThe extent of commitment to partner communities by service providers is still to be tested. The Hospice is carrying out further work to establish whether this will support more patients to achieve their preferred place of final care.Evaluation by Worcester University demonstrates communities willingness to engage with service providers and commissioners.
An innovative model for delivering end of life care education
Authors: Lansdell John , Mahoney Mary 
Published: September 2011

IntroductionThe care of patients at the end of life and their families has had an increasing profile since the publication of the End of Life Care Strategy. A central aspect of the strategy is education to improve the delivery of care at the end of life. Studies have shown that inadequate education and training results in suboptimal care at the end of life. Moreover, there are increasing difficulties in releasing staff to attend educational events. Therefore, we need to provide a more adaptable and responsive approach to the delivery of end of life care education.The modelThe End of Life Care Education and Training Model provides a flexible approach to supporting structured learning with an opportunity for reflective practice, enhancing professional development. Within this model we can tailor individual, departmental or organisational development plans that build competent practice to enhance end of life care. The model uses Bloom's taxonomy – a classification of the different levels of learning, advancing from basic levels of knowledge and application through to higher levels of analysis and evaluation – as the central building block for all professional development. Each aspect of the model provides a variety of options to support learning, for example: study days, seminars and courses considering different elements of a single topic; taking what has been learned and applying it to practical aspects of patient care; enabling staff to develop an outline of a skill set that supports competent practice.ConclusionThe intention of the model is to provide a framework for all healthcare practitioners working with people at the end of their lives to promote lifelong learning and therefore enhance patient care.
Tissue viability in the hospice setting: joint working and blended learning to develop and demonstrate competent practice
Authors: Myers Laura , Hailer Valerie 
Published: September 2011

Evidence suggests that 35% of people with life-limiting disease develop wounds towards the end of life and managing wounds in this population can be complex and challenging. The majority of the wounds, 50%, are decubitus ulcers and this is attributed to the “failure” of the skin and underlying tissues in the last days of life; acknowledgement of this enables better wound management, leading to enhanced patient comfort. A knowledge questionnaire on wound care demonstrated poor understanding among many of the nurses.Recently adopted hospice palliative care competencies require that healthcare assistants (HCAs) have knowledge of basic wound care and the ability to carry out simple dressings, while registered nurses (RNs) must be able to assess and manage complex wounds. With a team of over 50 nurses, our goal is to ensure consistency in the standard of wound care as well as a measure of that consistency.A 2-h classroom session has been delivered by hospice link nurses and a lecturer practitioner and includes tissue viability theory, holistic impact of wounds in palliative care and wound management, including aseptic non-touch technique (ANTT). All members of the inpatient unit nursing team are expected to attend a session as part of a compulsory training day. Additionally, they must complete a workbook on wound management that includes competency assessment, undertaken by an RN trained in teaching and assessing. In addition, all RNs must complete an online wound care management course and provide verification of the results.The outcome of this project is that wound management in the hospice is delivered to a consistent evidence-based standard, demonstrated by competent practice. Further, the link nurses have been supported to source appropriate evidence and share their tissue viability knowledge with the wider team.
Knowing yourself – understanding others – how an awareness of personality type can help with change
Authors: Pearce Sarah , Nash Sue 
Published: September 2011

IntroductionAs an intrinsic part of a major service redesign and implementation project, members of St Catherine's Community Team undertook a planned development programme focusing on personal and team development.The driver for this development programme was the implementation of a new Community Care Model to meet the Department of Health's End of Care Strategy that a ‘palliative care service should be available 24 h a day and 7 days a week in order to make it possible for those who want to die at home to do so.’The context of the development programme was, therefore, one of high change and challenge that saw 31 new members of staff joining the Community Nursing Teams including 2 new community team leaders.Part of this programme was a workshop on the theory of Personality Type. Extensive research over many years into personality types has shown that there are many personality related indicators that can impact upon the way in which people interact with one another.DiscussionThis presentation will highlight how the programme impacted on the teams who undertook the programme. By focusing on personality type with a reference to change we were able to explore why some people find change exhilarating while others find it overwhelming. These differences may be the cause of misunderstanding and miscommunication.Some of the things participants fed back were:-▶‘appreciating individual approaches to the same situation, neither being right or wrong – learning from each other’,▶‘Looking at personality type and how I modify approach to patients, also how I try to support colleagues’.Attention in the presentation will be given to how the programme impacted on the teams who undertook the programme and the impact this in turn had on patient care during a time of change.
Developing competencies for end of life care in care homes
Authors: Lansdell John , Mahoney Mary 
Published: September 2011

IntroductionEnd of life care is provided by generalists, often in the care home sector. Inadequate training and support can lead to suboptimal end of life care in care homes. The development of measureable competencies supported by education is essential to improve care delivery. This relies on working together as hospice competencies are not directly transferrable to the care home environment.AimTo improve end of life care in care homes in a sustainable way through the development of core competencies supported by education.MethodThis pilot project involved hospice staff working collaboratively with four local care homes. Year one developed a competency framework within each individual home informed by focus groups. Year two analysed competencies and identified key issues for inclusion in a 5-day training programme, tailored to address these issues in the broader context of palliative care. 15 care home staff attended the course, feeding back learning in their respective homes. The impact of the course on end of life care delivery was considered. Year three incorporated the competencies into existing staff appraisal systems. Senior care home staff were trained to assess competence, promoting sustainability of the competency work.ResultsEngaging care home staff in the development of competencies and identification of educational need is essential to ensure a tailored, relevant programme. Effective measurement of competence is achieved through appropriate assessment linked to staff appraisal. Opportunities for sharing learning throughout the process should be identified at an early stage.Discussion and conclusionsDeveloping a competency framework demonstrates an ongoing commitment to the development of staff and ultimately care home services, when supported by a tailored package of education. Working together is fundamental to success.
The butterfly project
Authors: Brownlee Debbie , Cook Audra , Bunce Alison , Rae Elaine , McEnhill Linda 
Published: September 2011

A new and innovative 5 year lottery funded service which involves collaborative working and shared policies across three independent Hospices in NHS Greater Glasgow and Clyde. It offers information, support and help to families with children and young people aged 2–18 years who are facing challenging times in coping with life limiting illness and bereavement, recognising that dealing with grief at an early age can prevent worsening emotional and mental health issues in later life. (Every Child Matters 2004).In the first year we successfully ran 2 groups; 5 teenagers then 5 children and worked individually with 47 others. They were offered a choice of counselling, play therapy or a mixture of both, at school, home or Hospice and were seen one to one using adapted models of established intervention (Winston's Wish and Solution Focused Care) or within a small age appropriate group. They were encouraged to talk about their feelings through interaction, play or arts and crafts.We have established training, trained volunteers and plan to train teachers to assist in setting up groups supporting bereaved young people.ResultsInitial evaluation of our teenage group identified that the young people appreciated being treated as equals, and the programme was adapted to extend the sessions following their feedback. We identified that getting children and young people together helped reduce the sense of isolation and helped them talk and learn about the grief process. The hospices have also agreed to extend bereavement support to other family members.Future plansA third group has just been completed and a fourth planned. We have also begun researching the needs of very young bereaved children aged 2–5 years highlighting the needs of this age group and the lack of awareness and training within nurseries. A website is to be established.
Support for coping with issues of loss in schools (SCILS)
Authors: Archer Nikki , Walker Jo 
Published: September 2011

Working in collaboration with local schools we developed an innovative programme of support to enable staff and pupils to cope with issues around loss and bereavement.We aimed to use our experience of working with young people living with grief to enable schools to be better prepared for a death in the school community and to normalise death and dying.Working in partnership with the schools we proposed a four tier triangle of service provision. The services were funded jointly by community money earmarked for ‘vulnerable children’ and investment from the hospice.We provided opportunities for staff, pupils and parents to learn about loss as part of life, through a varied programme of workshops and assemblies.We delivered training and resources which introduced staff to the bereavement pathway for schools, this equipped staff to respond appropriately to pupils experiencing loss and explored how they could offer proactive bereavement support.A strategy for identifying vulnerable children who required specialist bereavement support when grief became more complex was developed.The project was rolled out to 37 schools, representing over 11 000 pupils. Evaluations were received from 316 staff. 100% understood the aims of the bereavement pathway and felt they had the necessary skills to follow the policy, 80% felt they might require support to work with a bereaved pupil but all understood how to access this. 10 young people were referred for further bereavement support.This programme, not only met the needs which schools had identified but widened access to hospice care and facilitated community engagement opening a dialogue around death and dying in line with the government's EOLC strategy.We have been approached by numerous schools who were not part of the original project, and are currently working with them to develop a plan to roll the project throughout our catchment.
Pooling resources to drive quality; the evolution of the National Audit Tools Group (NATG)
Authors: Rodgers Carol , Flanagan Pauline , Thompson Andrew 
Published: September 2011

IntroductionRecognising the importance of audit in improving quality and the limited resources available in many hospices, Help the Hospices formed the NATG in 2004.AimTo pool expertise from across the hospice movement to develop a core range of hospice-specific audit tools that are available to all.MethodInitial membership comprised a small multi-professional team of hospice personnel with a specific interest in audit and quality. To establish an effective methodology, they started by developing audit tools relating to core areas of treatment and care.As more professionals volunteered to participate, the group expanded and subgroups were formed to develop new ranges of tools. The active involvement of experts from particular fields was sought to inform and strengthen this process.To encourage their widespread use, tools are designed to be user-friendly, and are trialled rigorously before release. Feedback from trials and subsequent usage has led to progressive improvements in design.ResultsRepresentatives from 29 hospices are members of the group/subgroups, and over 50 hospices have trialled new tools. 22 audit tools have been released to date and downloads from Help the Hospices website have averaged over 400 per month.Evolution of the group is ongoing with seven subgroups currently developing another 13 audit tools, including new families of tools for community services and children's hospices.DiscussionThe commitment of a broad range of personnel from different backgrounds, supported by their local hospices, has been key to the successful evolution of the NATG.Membership of subgroups or attendance at workshops provides excellent training opportunities.Possible future projects include e-learning, benchmarking and validation of locally-generated tools.ConclusionThe NATG has developed a highly effective model for pooling expertise to drive quality improvement by facilitating audit.
Demonstrate the quality of your bereavement service
Authors: Jane Elliott 
Published: September 2011

IntroductionTwo bereavement audit tools have been written to enable Hospices to collect crucial data to evidence high quality service provision based on national standards.AimsTo enable hospices to evidence the standard of their bereavement work using high quality audit tools.MethodsTwo audit tools were written by a collaborative group of bereavement service co-ordinators and audit professionals from different hospices. The tools fit together but look at different aspects of bereavement: the first enables audit of a bereavement service and the second audits bereavement care. It was an interesting challenge/struggle for the authors to understand these two different aspects of bereavement service provision when developing the tools.DiscussionWithin current health policy the tools enable hospices to look at how they might provide evidence to address the QIPP agenda and to be commissioned for services.In anticipation of GP commissioners looking for good value, having audit data available provides tangible evidence of the work of the bereavement service.Although bereavement care is acknowledged within Palliative care definitions it is only recently that the Department Of Health have recognised this – publication of ‘When A Patient Dies’ and the End Of Life Care Strategy, but there are no quality markers published within initial EOLC quality markers.The tools are referenced to all available National standards, have been piloted and reviewed assuring users of their quality. This quality has been recognised by other, non-hospice, organisations who have expressed interest in using the tools, as the key principles are transferrable.ConclusionWe encourage Hospices who do not have a bereavement service, as well as those who do, to use the tools. It will enable them to demonstrate the quality of their bereavement service and may assist them in identifying gaps and plan service developments.
Children's hospices services in Germany – a study on the quality of support
Authors: Schwarzenberg Eileen , Jennessen Sven , Bungenstock Astrid 
Published: September 2011

The first Children's Hospice in Germany was founded 1998. At present, there are 10 Children's Hospices which offer short breaks and 73 ambulant Children's Hospice services which provide support at the family's home.The aim of the first main study in the field of Children's Hospice services in Germany was to find out if Children's Hospices services offer the families the support they need, and how they evaluate the quality of the offers. Another aim was the development of guidelines for “Good Children's Hospice services”.In a first step in the mixed methods design 10 families who use the offers of Children's Hospice services were interviewed. Based on the results of this survey, a questionnaire was developed, and answered by 172 families.The findings showed that the offers of Children's Hospice services in Germany match the needs of families. 93% of the parents are ‘very satisfied’ or ‘satisfied’ with the support of their child or adolescent during a short break. 75% of the families are ‘very satisfied’ or ‘satisfied’ with the ambulant Children's Hospice service. However, there need to be made improvements in a number of areas, such as bereavement services, siblings support, cultural diversity, gender care and public relations.The results of the study illustrate that the aim to offer support for the families already reaches them. The findings may help to establish Children's Hospice services in Germany and thereby help to secure its future funding. The guidelines for “Good Children's Hospice services” are currently being discussed in many Children's Hospices services. They will be evaluated in a follow-up study.