Many patients and family prefer to have palliative care on the medical ward. Historically, managing patients in palliative care on the medical ward has presented some challenges, such as work stress and nurses’ skills and attitude (1, 2). I have been provided 2-day placement on the J.W. Whittle Palliative care unit in September to strength my knowledge and clinical skills in palliative care through the Program of Experience in the Palliative Approach (PEPA). Followed by the placement, I conducted palliative care in-service sessions on the 2A medical ward in October as my quality improvement project. The in-service used a case study based on a real patient to approach the principles of palliative care (Appendix A).
The in-service aimed to 1) share my experience from PEPA placement; 2) facilitate group discussion to improve quality of palliative care and patient experience on the medical ward; 3) enhance the palliative care principles. Registered nurses, enrolled nurses and student nurses from 2A medical ward attended these sessions, which hold during 1400-1500 for 30 minutes. The project was evaluated by the in-service feedback survey (Appendix B).
A total of 10 participants attended in-service sessions. Among them, seven were registered nurses, one was enrolled nurse and two were the student nurses. Most participants (83%) rated this in-service is helpful for them to understand the principles of palliative care and has increased their knowledge in palliative care. Most participants (67%) enjoyed communication with patients and family and holistic care part, some rated that they enjoyed malignant wound care part.
Due to the in-service were conducted before and after nursing hand-over. Only staff on the shifts were able to attend. Not all staff has attended the in-service. However, a written document regarding palliative care suggestions were sent to all staff by our manger via weekly email and additional resources including syringe driver medication compatibility and resources for patients and family were added into the end-of-life resources folder for references.
1. Terakado A, Matsushima E. Work stress among nurses engaged in palliative care on general wards. Psycho‐Oncology. 2015;24(1):63-9.
2. Ayed A, Sayej S, Harazneh L, Fashafsheh I, Eqtait F. The Nurses’ Knowledge and Attitudes towards the Palliative Care. Journal of Education and Practice. 2015;6(4):91-9.
To see Alexandra’s complete report Click Here