An evaluation of the impact of the Gold Standards Framework on collaboration in end-of-life care in nursing homes. A qualitative and quantitative evaluation
An evaluation of the impact of the Gold Standards Framework on collaboration in end-of-life care in nursing homes. A qualitative and quantitative evaluation
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DOI：
10.1016/j.ijnurstu.2011.10.021
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发表时间：
2012-05-01
影响因子：
8.1
通讯作者：
Clifford, Collette
中科院分区：
文献类型：
--
作者：
Badger, Frances;Plumridge, Gillian;Clifford, Collette
背景：在英国，85岁及以上的老年人中有近20%住在养老院，大多数人将在那里死亡。改善临终关怀是政府的一个卫生优先事项，家庭可以与初级保健工作人员和专业姑息治疗医生合作，提供全面的临终关怀。因此，护理之家和卫生服务从业人员之间的有效合作是至关重要的，以确保高质量的临终关怀。Objectives：To evaluate the impact of a training program to improve end of life care in nursing homes，on collaboration between nursing home staff and other health practitioners.Design：Evaluation using survey methods and qualitative case studies.Participants and setting：所有95个养老院在第一个国家的“金标准框架护理院”计划在England被邀请参加的evaluation.Methods：一项调查的家园的特点，结束了生命的护理，并与其他服务的联系，完成了前和后方案的实施。案例研究进行了10个家庭的子样本，提供重要的背景和深度的evaluation.Results：前后调查返回49（52%）的家园。31%的管理人员预计该方案将改善合作。合作面临的挑战包括与大量全科医生合作、非工作时间服务和获得专科医生服务。33%的管理人员认为，改善家庭工作人员和医疗服务从业者之间的合作是该计划的主要成果之一。工作人员报告说，他们对临终关怀的了解有所增加，信心有所增强，这反过来又改善了沟通和协作。方案后，工作人员感到更有信心发起接触和讨论居民的临终关怀与全科医生和那些工作在专科姑息治疗service.Conclusions：金标准框架护理家园计划可以有助于提高质量和数量的沟通和合作之间的养老院工作人员和初级保健和专科医生对临终关怀。需要进一步研究，以确定为什么这是不一致的所有家庭。(C)2011爱思唯尔有限公司保留所有权利。
Background: In the United Kingdom approaching 20% of people aged 85 years and over live in care homes and most will die there. Improving end-of-life care is a government health priority and homes may work with primary care staff and specialist palliative practitioners to provide comprehensive end-of-life care. Consequently effective collaboration between care home and health service practitioners is vital to ensure high quality end-of-life care.Objectives: To evaluate the impact of a training programme to improve end-of-life care in nursing homes, on collaboration between nursing home staff and other health practitioners.Design: Evaluation using survey methods and qualitative case studies.Participants and setting: All 95 nursing homes in the first national 'Gold Standards Framework in Care Homes' programme in England were invited to participate in the evaluation.Methods: A survey of homes' characteristics, the approaches to end-of-life care, and liaison with other services, was completed pre and post programme implementation. Case studies were conducted in a sub-sample of 10 homes to provide important context and depth to the evaluation.Results: Pre and post surveys were returned by 49(52%) homes. Improved collaborations as a result of the programme were anticipated by 31% of managers. Challenges to collaboration included working with large numbers of general practitioners, out-of-hours services and access to specialist practitioners. Improved collaborations between home staff and health service practitioners were identified by 33% of managers as one of the main programme outcomes. Staff reported increased knowledge of end-of-life care, and enhanced confidence, which in turn resulted in improved communication and collaboration. Post-programme, staff felt more confident initiating contact and discussing residents' end-of-life care with general practitioners and those working in specialist palliative care services.Conclusions: The Gold Standards Framework in Care Homes programme can contribute towards end-of-life care by helping to improve the quality and quantity of communication and collaboration between nursing home staff and primary care and specialist practitioners. Further research is needed to determine why this was not consistent across all homes. (C) 2011 Elsevier Ltd. All rights reserved.