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To explore the key advice healthcare professionals would give colleagues regarding end-of-life care delivery in hospitals, thereby informing training needs.
Exploratory qualitative study.
Free-text responses from medical, nursing, and allied health professionals who completed online end-of-life care education modules (n = 597) from August 2022 to September 2023 were analysed using inductive content analysis. Results were explored and separated into two key findings: themes that were shared by all professional groups and themes that were profession specific.
Five themes were consistent across all three professional groups: prioritise patient comfort, proactive communication, collaboration and inclusion, human approach and support and wellbeing, each with their own subthemes. Several profession specific subthemes were also identified.
The identification of common themes across healthcare professions helps to support the development of interprofessional training initiatives.
This research contributes valuable insights for developing targeted end-of-life care education programs. Results also underscore the potential of online learning platforms in providing accessible, evidence-based, continuing professional development in end-of-life care.
In Australia, most deaths occur in acute hospital settings. To inform and shape future training, this study collected the key advice healthcare professionals would give colleagues regarding end-of-life care delivery. The themes generated covered a range of potential training topics shared across all professionals, including prioritise patient comfort, proactive communication, collaboration and inclusion, human approach and support and wellbeing. Several profession-specific subthemes were also identified, providing additional insights for designing training for professional groups. Results underscore the potential of online learning platforms in providing accessible, evidence-based, continuing professional development in end-of-life care.
Standards for Reporting Qualitative Research (SRQR).
None.
To explore the views of community registered general nurses and directors of public health nursing on the current and future role of the community registered general nurse in the Republic of Ireland.
Anonymous cross-sectional descriptive survey.
Two questionnaires were developed; one targeted at community registered general nurses and one targeted at assistant directors of public health nursing or directors of public health nursing who were working with community registered general nurses. Social media was used to recruit participants. Descriptive statistics were used while data from open-ended questions were analysed using NVivo software.
A total of 97 community registered general nurses and 28 assistant directors of public health nursing or directors of public health nursing completed the surveys in 2023. There was consensus that community registered general nurses provide holistic care, including case management of adults with complex health needs living in the community. However, lack of promotional opportunities coupled with poor remuneration has resulted in job dissatisfaction. Respondents felt that community registered general nurses should focus on older adults, whereas public health nurses should focus on child health.
The role of the community registered general nurse needs to be clarified, and a promotional pathway developed to attract new graduates to this post.
This paper outlined the current role and vision for the future role of community registered general nurses.
CROSS guidelines.
No patient or public contribution.
This paper contributes to the challenges community nurses face regarding increased demand for community nursing, lack of career structure for some community nurses, and difficulties with staff retention within the community.
Patients and families from culturally and linguistically diverse (CALD) backgrounds face distinct challenges during end-of-life care (EOLC) in intensive care unit (ICU) settings, where communication, cultural expectations and decision-making may conflict with clinical norms. These complexities have important implications for intensive and palliative care teams.
To map literature on clinician, patient and family perspectives on end-of-life communication with CALD populations in ICUs, and identify barriers and facilitators to culturally responsive care.
This scoping review followed Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The protocol was registered with the Open Science Framework and published in BMJ Open. Screening, review and data extraction were conducted by multiple reviewers using Covidence and the Joanna Briggs Institute tool, with findings synthesised through inductive thematic analysis.
The primary outcome was to identify barriers and facilitators to communication between clinicians, patients and families from CALD backgrounds during EOLC. Secondary outcomes were to map the scope of evidence, describe study characteristics and participant demographics, and summarise themes on cultural sensitivity, clinician awareness, family involvement, decision-making and integration of support services.
Thirty of 766 screened studies were included. Three themes emerged: communication challenges; cultural sensitivity and humility and decision-making and support. Barriers included limited access to palliative care, language discordance, underuse of interpreters, clinician discomfort and conflicting care expectations. Facilitators included structured meetings, inclusive practices and interdisciplinary collaboration.
Structural, communicative and cultural barriers undermine equitable EOLC for CALD patients. Embedding palliative care principles, cultural responsiveness and shared decision-making into ICU practice requires coordinated input from a multidisciplinary team involving physicians, nurses, social workers, spiritual care, psychologists and interpreters. System-level reforms in training, service delivery and research are needed to ensure person-centred care.
Registered with BMJ Open DOI: 10.1136/bmjopen-2024-090168
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