Friday, July 23, 2004
This presentation is part of : End of Life/Palliative Care
An Investigation of Community-Based Palliative Care Services in a Regional Area Health Service in New South Wales, Australia
Mary Therese Cruickshank, PhD and Glenda Parmenter, N/A. School of Health, University of New England, Armidale, New South Wales, Australia
Learning Objective #1: Identify appropriate and cost-effective services required for a community-based palliative care service
Learning Objective #2: Identify potential service gaps in a community-based palliative care service

Objective: To assess the quality of end-of-life care services delivered in a regional health service in New South Wales, Australia. Design:A triangulation design was utilised for this study. Population, Sample, Setting, Years: The population were community-based nurses directly involved in the care of palliative care patients.The study was conducted in 2003 in a regional area of New South Wales and utilised a convenience sample of sixty nurses and fifty patients. Concept or Variables studied together: Palliative care patients and rural palliative care services. Methods:The study consisted of three stages. In Stage One, a Palliative Care Community-Based Nurses Survey was conducted while Stage Two obtained patient demographics and data on the delivery of palliative care services. The findings from both stages were further explored in a focus group discussion (Stage Three) with the nurses from Stage One. Findings: Findings showed that there is wide variation in palliative care service provision and delivery in the regional health service. The service gaps include inequitable service availability, monitoring and benchmarking of palliative care services, inadequate communication, education and training for those working in palliative care, and access to bereavement services. Conclusion: This study confirms the important role of community-based nurses directly involved in palliative care. However, addressing the identified service gaps is imperative if nurses are to appropriately meet the needs of the regional community and to assist patients when making end-of-life decisions and interventions. Implications: The key aspects of implementing a successful community-based palliative care service will be through the creation of a supportive structure with adequate funding, teamwork with regular and effective communication, and education and training for nurses involved in palliative care.A relentless focus on these key aspects has the potential to create a culture which is committed to long term quality improvement in a community-based palliative care service.

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Sigma Theta Tau International
July 22-24, 2004