Background

The ward accreditation process measures standards underpinned by the trusts Values and Behavioural Framework, Improving Quality Programme and the Nursing and Midwifery Strategy. The Supportive and Palliative Care Team have developed standards based on the national Ambitions Framework to be included in this process to assess and promote the delivery of high quality palliative and end of life care (PEOLC).

Methods

The standards were used across 5 divisions, including critical care. Nursing staff were interviewed using these standards and a ‘RAG’ rating system applied to analyse responses. The standards incorporated defined action plans for each division to complete.

Results

Common themes emerged from all clinical areas Identified Gaps in Practice: Staff members not involved in audit and monitoring of PEOLC on their ward. Clinical support staff not writing in the individualised plan of care for a dying adult. Senior staff unable to provide evidence of the number of staff who have undergone an annual reassessment in their competence to use a T34 syringe driver as per the strategy. Good practice identified: Staff can describe efforts required to improve the care environment for patients and carers. Wards have EOLC champions named on the EOLC board. Staff can describe how to access religious and spiritual support 24/7.

Conclusions

Acute trusts are important providers of PEOLC and it is vital that generalist ward staff are equipped with the right skills to be able to deliver excellent care. These standards provide a systematic structure within the accreditation process to assess this care and then further develop structured training and education programmes tailored to meet specific needs of ward staff. Further work is required in developing a more robust system of measurable outcomes using the standards which will strengthen our audit data and commitment to improving PEOLC practice across our generic nursing workforce.

Fiona Sharples

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