Dr Jianxia Zhai1, Ms Christine Mooney2, Dr Olivia HAMILTON1, Dr Gillian Vesty1, Ms Rebecca Millar1, Dr Fiona Runacres2, Dr Matthew Dellit2, Dr Barbora de Courten1
1RMIT University, Bundoora, Australia, 2Monash Health, Clayton, Australia
Biography:
Dr Jianxia Zhai completed her PhD at Monash University, Australia. Jianxia completed her Postdoctoral Research Fellow training in the Faculty of Health, Charles Darwin University. Jianxia founds great enthusiasm in research and teaching. Jianxia has an extensive experience in academic teaching in postgraduate and undergraduate students. As a researcher, Jianxia is highly experienced in qualitative methodologies (narrative inquiry, phenomenological study, grounded theory, to name a few), quantitative research and mixed methods designs. Jianxia has published over 20 papers in national and international peer-reviewed journals and participated in eight research projects as a primary or key investigator.
Abstract:
This study explored outcomes for patients at high risk of mortality, with a prognosis of three months or less, when a Palliative Care Nurse Consultant (PCNC) was embedded in a General Medicine team. The research also sought to understand feedback from patients, carers, and the perspectives of allied health and nursing professionals on integrating a palliative care approach in the ward.
A prospective observational study was conducted over six weeks in a general medicine ward at Monash Medical Centre, Melbourne, Australia, following SQUIRE reporting guidelines. Participants were patients aged over 65 years with non-malignant, chronic conditions and a high risk of mortality. Nursing and allied health professionals involved in their care were also included. Quantitative data were analysed descriptively, while qualitative survey responses were analysed thematically.
Twenty patients participated, with a mean age of 87 years. PCNC interventions such as care coordination and family liaison supported timely referrals to other support services, improved communication between teams and families, and strengthened end-of-life care planning. Health professionals acknowledged the benefits of PCNC involvement but also reported barriers, including time constraints, limited confidence in recognising patients suitable for palliative care, and patient or family resistance to referral.
Findings suggest that embedding a PCNC in a general medicine team enhances care coordination, supports early integration of palliative care, and improves communication. Addressing identified barriers and optimising workflow could further improve experiences for patients, carers, and clinicians while ensuring more efficient resource utilisation.
This model of practice has the potential to enhance patient-centred care and clinician confidence in acute care settings. The study provides international relevance by demonstrating a practical model for embedding palliative care, highlighting the role of PCNCs in improving coordination and early planning, and offering evidence to guide service redesign in general medicine wards worldwide.