May end of life current awareness by Musgrove Park Hospital Library

Library Services Musgrove Park and Somerset Partnership

Current Awareness End of Life This monthly Current Awareness Bulletin is produced by the Library, Musgrove Park Academy to provide staff with a range of resources focussing on end of life care. It includes recently published guidelines and research articles, news and policy items.

This guide provides a selection of resources relevant to the subject area and is not intended to be a comprehensive list. All websites have been evaluated and details are correct at the time of publications. Details correct at time of going to print. Please note that resources are continuously updated. For further help or guidance, please contact a member of library staff.

This guide has been compiled by: Jess Pawley Senior Library Assistant Musgrove Park Hospital Library Service jessica.pawley@tst.nhs.uk Issue 4 May 2016

Contents Click on a section title to navigate contents Page Results of Library Current Awareness Survey

Colleague App

Recent journal articles

Books

Guidelines

UpToDate

Reports, publications and resources

Topic Alerts and Updates

Twitter

Training & Networking Opportunities, Conferences, Events

Literature search service

Training and Athens

Library contact details: Library Musgrove Park Academy Musgrove Park Hospital Taunton Somerset TA1 5DA Tel: 01823 34 (2433)

Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

RESULTS OF LIBRARY CURRENT AWARENESS SURVEY BACK TO TOP

During 2015-6 the library team introduced a number of new current awareness bulletins as a result of feedback from staff. Along with the fortnightly Library Alert monthly updates were produced for: Dementia Stroke End of life Sign up to safety

Mentorship Cancer ITU

While we had some feedback that these bulletins were useful, we felt due to the cost in library staff time, it would be better to have more detailed evidence. We circulated the survey via email to the various email lists, added a link on the Library webpage and also put reminders in the Library Alert and Staff Bulletin. During the month when we received 211 replies on all bulletins covering both Taunton and Somerset and Somerset Partnership staff. The final report can be found here

COLLEAGUE APP BACK TO TOP The MPH Staff App has specifically been produced and designed to offer both current and future employees relevant information related to their work. Whether seeking information about policies and procedures, following us on Twitter or even taking advantage of special offers, all can be found here.

Library monthly current awareness bulletins are also available. To download, please follow this link Please note- The app has not been created by the library. If you have any problems downloading or accessing the app then you will need to contact the IT department.

RECENT JOURNAL ARTICLES BACK TO TOP This is a list of journal articles on the topic of end of life. Some articles are available in the library or on-line via an OpenAthens password by following the full-text link. If you would like an article which is not available as full-text then please contact library staff. Please note that abstracts are not always available for all articles. Some books from our electronic book collection- click on book cover and log in with your OpenAthens password to browse free online or to request access.

Title: Direct Engagement With Communities and Interprofessional Learning to Factor Culture Into End-of-Life Health Care Delivery. Citation: American journal of public health, Jun 2016, vol. 106, no. 6, p. 996-1001, 1541-0048 (June 2016) Author(s): Boucher, Nathan A Abstract: Aging patients with advanced or terminal illnesses or at the end of their lives become highly vulnerable when their cultural needs-in terms of ethnic habits, religious beliefs, and language-are unmet. Cultural diversity should be taken into account during palliative care delivery (i.e., noncurative, supportive care during advanced illness or at the end of life). Providers and systems deliver disparate palliative care to diverse patients. I present 2 strategies to improve how culturally diverse populations are served during advanced illness: (1) health service provider assessment of local populations to understand service populations' cultural needs and guide services and policy; and (2) interprofessional education to improve multicultural understanding among the health care workforce. Source: Medline Full text: Available EBSCOhost at American Journal of Public Health Full text: Available EBSCOhost at American Journal of Public Health Full text: Available EBSCOhost at American Journal of Public Health ________________________________________________________________________________ Title: Guidelines for the withdrawal of life-sustaining measures. Citation: Intensive care medicine, Jun 2016, vol. 42, no. 6, p. 1003-1017, 1432-1238 (June 2016) Author(s): Downar, James, Delaney, Jesse W, Hawryluck, Laura, Kenny, Lisa Abstract: Withdrawal of life-sustaining measures is a common event in the intensive care unit yet it involves a complex balance of medical, legal and ethical considerations. Very few healthcare providers have been specifically trained to withdraw life-sustaining measures, and no comprehensive guidelines exist to help ensure clinicians deliver the highest quality of care to patients and families. Hence, we sought to develop guidelines for the process of withdrawing life-sustaining measures in the clinical setting. We convened an interdisciplinary group of ICU care providers from the Canadian Critical Care Society and the Canadian Association of Critical Care Nurses, and used a modified Delphi process to answer key clinical and ethical questions identified in the literature. A total of 39 experienced clinicians completed the initial workshop, and 36 were involved in the subsequent Delphi rounds. The group developed a series of guidelines to address (1) preparing for withdrawal of life-sustaining measures; (2) assessment of distress; (3) pharmaceutical management

of distress; and (4) discontinuation of life-sustaining measures and monitoring. The group achieved consensus on all aspects of the guidelines after the third Delphi round. We present these guidelines to help physicians provide high-quality end of life (EOL) care in the ICU. Future studies should address their effectiveness from both critical care team and family perspectives. ________________________________________________________________________________ Title: Education in End-of-Life Care: What Do Experienced Professionals Find Important? Citation: Journal of cancer education : the official journal of the American Association for Cancer Education, Jun 2016, vol. 31, no. 2, p. 272-278, 1543-0154 (June 2016) Author(s): Jors, Karin, Seibel, Katharina, Bardenheuer, Hubert, Buchheidt, Dieter, Mayer-Steinacker, Regine, Viehrig, MarĂŠn, Xander, Carola, Becker, Gerhild Abstract: End-of-life care is an essential element of quality cancer care. Nevertheless, a majority of physicians and nurses working at cancer centers feel unprepared for this task. As part of a larger survey study, we investigated what suggestions experienced physicians and nurses have to improve education/training on end-of-life care. In an open question, participants were requested to suggest changes to the end-of-life curriculum for physicians and nurses. Answers to this question were content analyzed using the qualitative data analysis software MAXQDA. Physicians and nurses at 10 cancer centers throughout Baden-Wuerttemberg were surveyed. From the total 1131 survey participants, 675 (483 nurses, 167 physicians, 25 unknown) responded to the open question regarding suggestions for education/training in end-of-life care. Two main categories were inductively developed: (1) format (i.e., structure and method of teaching) and (2) content (i.e., knowledge and know-how required for care of the dying). Regarding format, both professional groups most often wished for more practical experiences with dying patients (e.g., internships at hospices). Regarding content, physicians and nurses most frequently requested (1) more basic information on palliative care, (2) increased skills training in communication, and (3) knowledge of how to appropriately care for patients' caregivers. The results of our analysis reflect already trained physicians' and nurses' interest in furthering their knowledge and skills to care for dying patients. The suggestions of experienced physicians and nurses should be integrated into the further development of palliative care curricula. ____________________________________________________________________________ Title: Pharmacologic pain management at the end of life. Citation: The Nurse practitioner, May 2016, vol. 41, no. 5, p. 26-37, 1538-8662 (May 19, 2016) Author(s): Davies, Pamela Stitzlein Abstract: Escalating pain is common in the final weeks of life, requiring skilled management to assist patients with a life-limiting illness. Using a cancer model, pharmacologic approaches to treat pain in the final weeks of life are reviewed. _____________________________________________________________________________ Title: Critical Care Nurses' Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients. Citation: American journal of critical care : an official publication, American Association of CriticalCare Nurses, May 2016, vol. 25, no. 3, p. 206-211, 1937-710X (May 2016) Author(s): Canfield, Christina, Taylor, Debi, Nagy, Kimberly, Strauser, Claire, VanKerkhove, Karen, Wills, Stephanie, Sawicki, Patricia, Sorrell, Jeanne Abstract: The term spirituality is highly subjective. No common or universally accepted definition for the term exists. Without a clear definition, each nurse must reconcile his or her own beliefs within a

framework mutually suitable for both nurse and patient. To examine individual critical care nurses' definition of spirituality, their comfort in providing spiritual care to patients, and their perceived need for education in providing this care. Individual interviews with 30 nurses who worked in a critical care unit at a large Midwestern teaching hospital. Nurses generally feel comfortable providing spiritual care to critically ill patients but need further education about multicultural considerations. Nurses identified opportunities to address spiritual needs throughout a patient's stay but noted that these needs are usually not addressed until the end of life. A working definition for spirituality in health care was developed: That part of person that gives meaning and purpose to the person's life. Belief in a higher power that may inspire hope, seek resolution, and transcend physical and conscious constraints. Full text: Available EBSCOhost at American Journal of Critical Care ________________________________________________________________________________ Title: Addressing the challenges of conducting research with end-of-life populations in the acute care setting. Citation: Applied nursing research : ANR, May 2016, vol. 30, p. 12-15, 1532-8201 (May 2016) Author(s): Whitehead, Phyllis B, Clark, Rebecca C Abstract: End-of-life (EOL) conversations are difficult for patients, families, and nurses. The purpose of this article is to describe the challenges encountered and strategies implemented during a research study designed to elicit information about the congruence among patients' stated preferences at EOL with perceptions of their caregivers and nurses using the Preferences About Dying and Death (PADD) instrument in an acute care setting. With the proper study inclusion criteria, education and support from more confident, experienced colleagues, nurses can be coached to identify appropriate participants for EOL research. Researchers should plan regularly scheduled debriefing sessions with interviewers to provide emotional support and encouragement to minimize distress. A scripted approach to introduce EOL research topics can ease clinicians' discomfort while allowing patients the opportunity to have open, honest dialogues about their care preferences. By proactively implementing strategies, researchers can enhance the integration of EOL research into the acute care setting. ________________________________________________________________________________ Title: Development and efficacy of music therapy techniques within palliative care. Citation: Complementary therapies in clinical practice, May 2016, vol. 23, p. 125-129, 1873-6947 (May 2016) Author(s): Clements-CortĂŠs, Amy Abstract: Music therapy is increasingly becoming an intervention used in palliative care settings around the globe. While the specialty of palliative care music therapy is relatively young having emerged in the late 1980s, there is a strong and growing body of evidence demonstrating its efficacy in assisting a variety of issues common at end-of-life. There are multiple music therapy techniques that are implemented with clients in palliative care and they can be categorized in four broad areas: receptive, creative, recreative and combined. These techniques will be presented with respect to their development by clinicians as supported by the descriptive and research literature. Information is also provided on the use of music therapy in facilitating the grieving and bereavement process. ______________________________________________________________________________

Title: Dying with dignity: a concept analysis. Citation: Journal of clinical nursing, May 2016, vol. 25, no. 9-10, p. 1218-1228, 1365-2702 (May 2016) Author(s): Hemati, Zeinab, Ashouri, Elaheh, AllahBakhshian, Maryam, Pourfarzad, Zahra, Shirani, Farimah, Safazadeh, Shima, Ziyaei, Marziyeh, Varzeshnejad, Maryam, Hashemi, Maryam, Taleghani, Fariba Abstract: This article is a report of an analysis of the concept of dying with dignity. Dignity is an important component of providing care for dying patients and their families. Nevertheless, given that this concept is poorly defined, concept analysis is one of the best ways to define and clarify the concept of death with dignity with the aim to enhance its application in clinical practice, research and education. A search of multiple nursing and social sciences databases was undertaken, including Academic Search Complete, Science Direct, ProQuest, Scopus, Medline, PubMed, EBSCO, Ovid, Noormage, Cinahl, Magiran, PsycINFO and SID. After an extensive review of the literature from 1998-2014, about 14 related articles were included in the study. Based on these articles, the applications, attributes and experimental results of and references to death with dignity were recorded. Based on this analysis, the most important attributes of this concept included respect for privacy, respect, spiritual peace and hope. The antecedents of this concept included consideration of moral values during caregiving, preservation of human dignity as a patient right and professional ethics, and belief in the dignity of self and others, consideration of culture in providing end-of-life care. The consequences of this concept included a sense of peace in the patient and their family, peaceful death and provision of patient privacy and comfort. The concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. Respecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death. ______________________________________________________________________________ Title: Loss of Dignity in End-of-Life Care in the Emergency Department: A Phenomenological Study with Health Professionals. Citation: Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association, May 2016, vol. 42, no. 3, p. 233-239, 1527-2966 (May 2016) Author(s): Granero-Molina, José, Díaz-Cortés, María Del Mar, Hernández-Padilla, José Manuel, García-Caro, María Paz, Fernández-Sola, Cayetano Abstract: The objective of this study was to explore and describe the experiences of physicians and nurses with regard to loss of dignity in relation to end-of-life care in the emergency department. A phenomenological qualitative study was performed. Two focus groups and 12 individual interviews were conducted with a total of 26 participants, who had attended to patients in the emergency department an average of 14.3 years. An inductive analysis was carried out with the use of ATLAS.ti software to seek emerging themes. Three themes that helped us understand the phenomenon of the loss of dignity in end-of-life care in the emergency department emerged: (1) "Being exposed in a cold world," with the subthemes "improvising dying person care" and "a lack of space to care for the dying person"; (2) "Being selfcritical with professional attitudes," with the subthemes "being aware of undignified actions" and "lack

of a palliative culture"; and (3) "Family obstinacy and hospital rescue," with the subthemes "making illadvised choices" and "avoiding burden." The dignity of people who are taken to the emergency department at the end of their life could be undermined by architectural and organizational characteristics, professionals' attitudes, and decisions made by family members. ________________________________________________________________________________ Title: Interdisciplinary Team Care and Hospice Team Provider Visit Patterns during the Last Week of Life. Citation: Journal of palliative medicine, May 2016, vol. 19, no. 5, p. 482-487, 1557-7740 (May 2016) Author(s): Ellington, Lee, Clayton, Margaret F, Reblin, Maija, Cloyes, Kristin, Beck, Anna C, Harrold, Joan K, Harris, Pamela, Casarett, David Abstract: Hospice provides intensive end-of-life care to patients and their families delivered by an interdisciplinary team of nurses, aides, chaplains, social workers, and physicians. Significant gaps remain about how team members respond to diverse needs of patients and families, especially in the last week of life. The study objective was to describe the frequency of hospice team provider visits in the last week of life, to examine changes in frequency over time, and to identify patient characteristics that were associated with an increase in visit frequency. This was a retrospective cohort study using electronic medical record data. From U.S. not-for-profit hospices, 92,250 records were used of patients who died at home or in a nursing home, with a length of stay of at least seven days. Data included basic demographic variables, diagnoses, clinical markers of illness severity, patient functioning, and number of hospice team member visits in the last seven days of life. On average the total number of hospice team member visits in the last week of life was 1.36 visits/day. Most were nurse visits, followed by aides, social workers, and chaplains. Visits increased over each day on average across the last week of life. Greater increase in visits was associated with patients who were younger, male, Caucasian, had a spouse caregiver, and shorter lengths of stay. This study provides important information to help hospices align the interdisciplinary team configuration with the timing of team member visits, to better meet the needs of the patients and families they serve. ________________________________________________________________________________ Title: Interprofessional Education Using a Palliative Care Simulation Citation: Nurse Educator, May 2016, vol. 41, no. 3, p. 125-129, 0363-3624 (May-Jun 2016) Author(s): Saylor, Jennifer, Vernoony, Stephanie, Selekman, Janice, Cowperthwait, Amy Abstract: This quasi-experimental pretest-posttest study measured self-efficacy, attitudes toward physician-nurse collaboration, and interprofessional competencies as outcomes of a palliative care simulation. Based on experience level, teams of participants, 1 consisting of nursing/medical students and the other of nursing/medical health care professionals, completed a palliative care simulation as part of their education. Self-efficacy and attitudes toward physician-nurse collaboration were measured before and after simulation. Interprofessional competency was measured during the simulation. The results revealed a significant improvement in the previously mentioned measures, and interprofessional competency scores varied by profession and evaluator.

BOOKS BACK TO TOP If you are unable to find a book, or require a book that is not on this list, please ask library staff who will be able to locate the book for you using interlibrary loan. Please note that some books detailed below may not be available in your local library and would need to be ordered for you. Some books from our electronic book collection- click on book cover and log in with your OpenAthens password to browse free online or to request access.

Palliative care nursing: quality care to the end of life Matzo, M et al th 4 edition, 2015

Palliative care in nursing and healthcare Brown, M 2016

From the back of the book: Palliative Care Nursing continues to reflect the fundamental hospice and palliative care nursing competencies---both basic and advanced--that are essential for effective and empathetic care of patients and families. This new edition reflects the tremendous growth of this vital discipline into the mainstream of health care and focuses on palliative care that is responsive to the demand for health care reform in America and globally. It provides the knowledge, scientific evidence, and skills needed by nurses to address the complex physical, emotional, social, sexual, and spiritual needs of patients and families within the context of a changing health care delivery system. With a focus on inter-professional collaboration, the book emphasizes the value of complementary, holistic models in promoting health and wholeness across the illness trajectory, even as death approaches.

From the back of the book: This book helps nursing and healthcare students to prepare for the challenges of working with the increasing number of patients requiring palliative care, so that they can work in partnership with patients and their carers, providing care that is compassionate, practical and backed up by the latest evidence. Delivering palliative care can be emotionally challenging and the book focuses on supporting healthcare staff, allowing them to provide the care that is needed. Palliative Care in Nursing and Healthcare is suitable for undergraduate nursing students and allied health students and practitioners.

Taunton and SomPar NHS staff - Have you visited the EBL eBook catalogue? Follow the links below and login via OpenAthens to read online books free for 5-10 minutes each day, send requests for eBook loans or purchase suggestions eBook catalogue

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GUIDELINES

UPTODATE BACK TO TOP Whatâ&#x20AC;&#x2122;s new from our clinical decision-making tool on the topic of end of life care. UpToDate (Access for Musgrove Park Staff only) Please contact library staff for details on how to access these resources; you will need an Athens password.

REPORTS, PUBLICATIONS AND RESOURCES BACK TO TOP SCIE (Social Care Institute for Excellence) End of Life Care National Council for Palliative Care

European Association for Palliative Care European Association for Palliative Care th

14 World Congress of the European Association for Palliative Care- information from the 14 World Congress of the European Association for Palliative Care, held in May 2015 Royal College of Physicians Palliative and end of life care toolkit National Institute for Health Research Themed review- Better Endings: Right care, right place, right time

NHS England Transforming end of life care in hospitals: the route to success ‘how to’ guide e-Learning for Healthcare End of life care: e-learning modules to support NICE Guideline NG31 Care of Dying Adults in the Last Days of Life

NEW National Council for Palliative Care report The National Council for Palliative Care (NCPC) have published a new report Staff prepared to care? Capacity and competence in the end of life care workforce. CQC Review A different ending: End of life care review This review of end of life care found that people from certain groups in society sometimes experience poorer quality care because providers do not always understand or fully consider their needs. In light of this, the report argues that some commissioners and providers might not be fulfilling their duties under the Equality Act 2010 as all public bodies have a legal duty to consider the needs of a range of equality groups when carrying out their day-to-day work. The review identified examples of good practice, but found that action is needed to make sure everyone has the same access to high quality, personalised care at the end of their lives, regardless of their diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances. Hospital at home increases the chances of dying at home It’s Dying Matters Awareness Week, an opportunity to place the importance of talking about dying, death and bereavement on the national agenda and to share Cochrane evidence that may help inform choices for those at the end of life and those caring for them. Here, Palliative Medicine doctor Anna Sutherland shares her thoughts on a Cochrane review on hospital at home. A different ending: addressing inequalities in end of life care. The Care Quality Commission has published a suite of documents under the collective title. The documents have been produced as part of the CQC end of life care thematic review and are designed to be read in conjunction with each other. They include an overview report, people’s experience briefings and examples of good practice case studies. The review looks at ‘how dying patients are treated across various settings’. In particular, it focused on end of life care for people who may be less likely to receive good care, whether because of diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances. RCGP conducts a survey to understand the state of end of life care Practice managers, district nurses and GPs are being urged to complete a survey about the state of end of life care. The questionnaire has been put together by the Royal College of General Practitioners (RCGP) and cancer charity Marie Curie. It aims to help the RCGP develop better educational support for GPs. The results will also be used to back up calls for financial support and political backing for staff delivering end of life care. CQC to rate GP practices on end-of-life care GP practices will be given an additional rating assessing the quality of end-of-life care they provide to patients so they can be compared more easily with other service providers, the CQC has announced.

TOPIC ALERTS AND UPDATES BACK TO TOP ABSTRACTS AVAILABLE VIA LINKS BELOW- FOR FULL-TEXT PLEASE ASK LIBRARY STAFF

Practice development using video-reflexive ethnography: promoting safe space(s) towards the end of life in hospital International Practice Development Journal 6 (1) [3] FREE FULL TEXT NHS Evidence The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psychooncology. 2016 May 1. doi: 10.1002/pon.4140. [Epub ahead of print] TRIP Database Advanced cancer patients' reported wishes at the end of life: a randomized controlled trial. Support Care Cancer. 2016 May 10. [Epub ahead of print] How integrated are neurology and palliative care services? Results of a multicentre mapping exercise BMC Neurol. 2016; 16: 63. Published online 2016 May 10 FREE FULL TEXT Educational interventions to train healthcare professionals in end-of-life communication: a systematic review and meta-analysis BMC Med Educ. 2016 Apr 29;16(1):131. Healthcare staffâ&#x20AC;&#x2030;'s experience in providing end-of-life care to children: A mixed-method review. Palliat Med. 2016 Apr 29. [Epub ahead of print]

TWITTER BACK TO TOP The latest from popular Twitter pages dedicated to end of life care: End of Life Studies @EndofLifeStudy Public Health Palliative Care @PHPalCare European Association for Palliative Care @EAPCOnlus Cicely Saunders Institute @CSI_KCL Palliative Medicine Journal @PalliativeMedJ

TRAINING & NETWORKING OPPORTUNITIES, CONFERENCES, EVENTS BACK TO TOP

9 World Research Congress of the European Association for Palliative Care- 9 -11 June 2016, Dublin th

15 World Congress of the European Association for Palliative Care- 11 -13 May 2017, Madrid th

5 International Public Health and Palliative Care Conference- 18 - 20 September 2017, Ottawa, Ontario, Canada- Includes links to past conferences and presentations

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but havenâ&#x20AC;&#x2122;t got time to trawl the databases? Do you need a literature search carried out? Do you need to find evidence to support an improvement? Do you want to know how something has been done elsewhere and whether it worked?

Library staff provide a literature search service for busy clinicians who are pressed for time.

To request a search please complete and return the appropriate form, providing as much information as possible. Alternatively if you would like an assisted search training session, where we will sit down with you and go through the steps of a literature search, then please contact the library. Musgrove staff click here to access literature search form Somerset Partnership staff click here to access literature search form

TRAINING AND ATHENS BACK TO TOP Most electronic resources are available via an Athens password. You can register for this via the Library intranet page, or from home at www.swice.nhs.uk and following the link for Athens selfregistration. Please note that registering from home will take longer as it will need to be verified that you are NHS staff/student on placement. The library offers training on how to access and use Athens resources, as well as an introductory course on critical appraisal. You can book a course through the Learning and Development intranet page, or by contacting the library directly.