Unit Learning Outcomes and Deakin Graduate Learning Outcomes
The two research articles annotated above focus on the improvements needed for ensuring that palliative care is provided in a more robust manner in the future to the target population. From the research of Beernaert et al., (2017) it can be inferred that programs such as the Care Program for the Last Days of Life (CAREful) would be helpful in improving the quality of end-of-life care in acute geriatric hospital wards. The program had been developed on the basis of three existing programs from across the globe. The research identified a clinically significant and statistically significant advancement in comfort around dying when assessment was carried out by nurses. It was also pointed out that an important effect was present on the care needs and symptoms, which was positive. However, a negative effect could be noticed in terms of impact on the satisfaction level with care. In the study, the multiple components of CAREful strived to bring improvement in effective communication between the healthcare professionals, and the patient about to die and the family members. The underlying concept is to inhibit inappropriate interventions as improve management of symptoms. This would be made possible with the help of onsite professional training. The different components of CAREful were found to be helpful for health-care professionals to deliver care in a better manner.
The study of Baillie et al., (2018) focused on analyzing the experiences of patients, carers and health professionals in relation to symptom management, hydration and nutrition at end of life. It was reported that while management of symptoms could be successful, there were significant concerns related to hydration and nutrition. Patients are in need of being delivered more advanced care that is based on evidences. Poor controlled symptoms were evident from the research through supplementary analysis of the responses. Carers pointed out that patient are unable to report pain due to impairment in verbal communication. Healthcare professionals pointed out that there is a need of determining the hydration and nutrition needs of the patients at the end of life care. Further, concerns were highlighted through the study in relation to the place of car and whether symptoms could be managed better at home or in hospital. Patients reported high levels of dissatisfaction with care being delivered by non-specialist palliative care healthcare professionals. It was therefore inferred that further recommendations are needed for reducing harm to patients and reducing distress for both care providers and patients.
At this juncture it is to be mentioned that both the research articles considered for the present analysis had certain limitations and strengths. The research of Beernaert et al., (2017) was the first sufficiently powered randomised controlled trial that considered assessing the benefits and effectiveness of an end-of-life care program. However, the study had certain limitations. While high response rates were achieved for nurses, the response for carers was low. Though the insights given by family members provided a distinct idea of the care giving triangle existing between professional carers, family and patients, it might have been difficult to interpret certain outcomes since the response provided by the carer was low (LoBiondo-Wood & Haber, 2014). Further, the study was a quantitative analysis, and a qualitative methodology would have been more appropriate to explore the unexpected result of limited family satisfaction with care provided. The study of Baillie et al., (2018) had been successful in carrying out a qualitative study for exploring experiences and perceptions of individuals in relation to palliative care delivery. Qualitative studies are beneficial in carrying out a comprehensive exploration of certain phenomena and the underlying driving factors for them (Moule et al., 2016). Nevertheless, the study had certain limitations. The researchers were not able to clarify appropriately the reports of the respondents and illicit more in-depth information as deemed fit for qualitative interviews (Parahoo, 2014).
Paraphrasing and Direct Quotations
In spite of the limitation of the two articles, the implications for practice are noteworthy. As per the estimates of World Health Organization, around 20 million individuals are in need of appropriate palliative care on an international level every year. Palliative care refers to the form of care provided for bringing improvement in the quality life of individuals as well as their families who experience challenges related to life threatening diseases (Zimmermann et al., 2014). It has been noted that accessing specialist palliative increases the chances of dying in a preferred environment of care since the burden of symptoms is reduced to a considerable extent. A specially trained team of professionals, including nurses, are entailed to work in collaboration with each other for providing an additional layer of support to those who are the end stage of their lives (Kelley & Morrison, 2015). As mention by Etkind et al., (2017) nurses working in the palliative care unit are required to address complex conditions and communicate effectively for supporting the diverse need of the patient population. An increasing need has been felt regarding conducting research studies that highlight how palliative care might be made better along with the implications of better professional practice for healthcare professionals.
Based on the findings of the two research papers and a subsequent analysis, it can be stated that there is a need of future research that would have more robust research methodology while assessing the needs of improving palliative care (Parahoo, 2014). At present, it is evident that is a gap in providing optimal palliative care to patients presenting diverse needs. These are mainly in relation to management of symptoms, dehydration and nutrition. Since the level of patient and family member dissatisfaction is high, nurses and other healthcare professionals are to find out novice and effective strategies through which care delivery can be improved (Glover et al., 2017). Programs such as CAREful can be implemented for improving palliative care in geriatric wards. Such program would target the geriatric healthcare staff, including the nurses. The aim would be to raise awareness level of improving care delivery and preparing the staff for bringing about changes in care practices. The healthcare organizations must allocate resources for training the staff and implementing such programs. Professionals are also required to show interest to take part in professional development activities to support the implementation of such program aiming at better care delivery across the continuum of palliative care (Harden et al., 2017).
References
Baillie, J., Anagnostou, D., Sivell, S, Van Goodwon, J., Byrne, A. & Nelson, A. (2018). Symptom management, nutrition and hydration at end-of-life: a qualitative exploration of patients’, carers’ and health professionals’ experiences and further research questions. BMC Palliative Care, 17, 60. doi:https://doi.org/10.1186/s12904-018-0314-4
Beernaert, K., Smets, T., Cohen, J., Verhofstede, R., Costantini, M., Eecloo, K., & … Deliens, L. (2017). Improving comfort around dying in elderly people: a cluster randomised controlled trial. Lancet, 390 North American Edition (10090), 125-134. doi:10.1016/S0140-6736(17)31265-5
Etkind, S. N., Bone, A. E., Gomes, B., Lovell, N., Evans, C. J., Higginson, I. J., & Murtagh, F. E. M. (2017). How many people will need palliative care in 2040? Past trends, future projections and implications for services. BMC medicine, 15(1), 102. DOI https://doi.org/10.1186/s12916-017-0860-2
Glover, T. L., Horgas, A. L., Castleman, J., Turpening, P., & Kittelson, S. (2017). An experiential learning approach to primary palliative care nursing education: the comfort shawl project. Journal of Hospice & Palliative Nursing, 19(6), 534-538. DOI 10.1097/NJH.0000000000000381
Harden, K., Price, D., Duffy, E., Galunas, L., & Rodgers, C. (2017). Palliative Care: Improving Nursing Knowledge, Attitudes, and Behaviors. Clinical journal of oncology nursing, 21(5), E232-E238. DOI 10.1188/17.CJON.E232-E238
Kelley, A. S., & Morrison, R. S. (2015). Palliative care for the seriously ill. New England Journal of Medicine, 373(8), 747-755. DOI 10.1056/NEJMra1404684
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
Moule, P., Aveyard, H., & Goodman, M. (2016). Nursing research: An introduction. Sage.
Parahoo, K. (2014). Nursing research: principles, process and issues. Macmillan International Higher Education.
Zimmermann, C., Swami, N., Krzyzanowska, M., Hannon, B., Leighl, N., Oza, A., … & Donner, A. (2014). Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. The Lancet, 383(9930), 1721-1730. DOI https://doi.org/10.1016/S0140-6736(13)62416-2
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
