Journal of Primary Care and General Practice

Palliative care in a home care setting; the development of a guideline for district nurses and nurse assistants

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

Els M L Verschuur,van der Sande R and Francke A L

HAN University of Applied Sciences, The Netherlands Nivel, Utrecht & Amsterdam UMC, The Netherlands

Keynote : J Prim Care Gen Pract

Abstract:

Background: In the Netherlands district nurses and nurse assistants have a pivotal role in palliative care at home. Partly due to aging of society, an increase of palliative care is expected. Related to this, we developed a guideline Palliative Care at Home for district nurses and nurse assistants.

Methods: This guideline is developed following the standard of the Dutch AQUA-Advisory and Expert Group. To assess the bottlenecks in daily practice, face to face and online focus groups with district nurses and nurse assistants were performed. Seven predefined questions were answered by a systematic international literature review of existing systematic literature reviews and evidence-based guidelines in the field of palliative care at home. The AMSTAR and AGREE II criteria were used to assess the methodological quality.

Results: The 41 recommendations covered four themes: support of self-management among patients; identification of the palliative phase and needs assessment; advance care planning and competences of district nurses and nurse assistants. All four themes are structured as follows: predefined questions, recommendations, results of the literature review and other considerations. To obtain overall agreement on each recommendation, all recommendations were thoroughly discussed in the multidisciplinary project group and advisory group with representatives of key stakeholders in palliative care. This resulted in both evidence-based and consensus-based recommendations. Two examples of recommendations are: 1) District nurses and nurse assistants plan patient centered palliative care, taking into account the values, wishes, needs and expectations of patients and those of their relatives, and 2) District nurses and nurse assistants discuss the outcome of the‘surprise question’with the general practitioner if the answer to that question is: ‘No, I would not be surprised’.

Conclusions: This guideline provide recommendations concerning key aspects of palliative care at home by district nurses and nurse assistants. They should serve as a reference standard for providing palliative nursing care and for collaboration with the interdisciplinary team around patients, in particular with the general practitioner.

Biography:

Els M L Verschuur has a background in nursing. She is a Bachelor Nurse (not practicing) and studied Nursing Sciences at the University of Utrecht, The Netherlands. She has completed her PhD in 2007 from Erasmus University Medical Center, The Netherlands. She has over 50 publications and is serving as an editorial member of the Dutch Flemish Scientific Journal ‘Verpleegkunde’. She is a member of Sigma Theta Tau at Large chapter Rho Chi. She is working at HAN University of Applied Sciences in Nijmegen The Netherlands as a Lecturer Advisor and Senior Researcher.

E-mail: Els.Verschuur@han.nl

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