Journal of Primary Care and General Practice

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +44-7360-538437

Could mobile team improve palliative care in nursing homes?

2nd International Conference on Palliative Care
September 23-24, 2019 | Prague, Czech Republic

Cernesi Simone

Ausl Modena, Italy

Scientific Tracks Abstracts : J Prim Care Gen Pract


Background: According to Bone research deaths occurring in care homes in the UK could more than double in the next 25 years if trends continue. Our Mobile team tries to struggle with this challenge. The team consists of a General Practitioner PC expert, Nurse PC expert, and Psychologist. We established a mobile team that visits all the public nursing home (NH) regularly.

Objectives: Find target patients. Involvement of the multiprofessional team help to define Advanced Care Plan or Anticipate Care Plan. Symptoms control and Therapy modulation. Audit in difficult cases. Different kind of intervention (phone calls, NH visits, writing reports).

Method: Peer education. Other aims are data collection and promote reflective learning.

Results: From May 2018 to September 2018 we have helped to find 56 cases (10 are in charge, 46 dies). We performed 20 on site consultations. We performed PC consultations in 8 Nursing homes. We performed 3 audits for difficult cases. In 3 cases we facilitated the PC specialist, in 3 cases we suggested psychologist. More than 95% died in NH with symptom control. We help to define Advanced Care Plan for every patient.

Conclusion: We have to consider NH as Large diffuse Hospice. Our team seems to be efficient to help to find the case and we have positive feedback from the staff. We have avoided hospitalization in >90% of the cases we have been in contact. Most of the difficulties (>60%) concerned the relationships with the caregiver. Still difficult to estimate prognosis but most of the target patient died in 5 months. We use Focus group to maintenance this project.


Cernesi Simone is from Modena, Italy. He graduated in Medicine
(the University of Modena and Reggio Emilia) in 2008 he is a General
Practitioner in Modena. He works in a nursing home and he is palliative
care consultant, tutor of Family Medicine. He led Movimento Giotto
palliative care and Intermediate care interest group. He has MSc degree
in Palliative Care (ASMEPA-University of Bologna) MSc in Geriatric
Medicine (University of Pavia) attended the European Palliative Care
Academy leadership course (EUPCA) in 2015-2017, he participated
in different International Palliative Care trainings (Houston, Oxford,
Pamplona, Amsterdam, Rotterdam).

E-mail: [email protected]

Get the App