Mrs Melinda Mitchell1, Dr Jordana Hughes, Associate Professor Jennifer Weil, Associate Professor Mark Boughey
1St Vincent's Hospital Melbourne, Palliative Care Consultation Service, Fitzroy, Australia
Biography:
Melinda Mitchell – Palliative Care Consultation Service [PCCS] Acute Setting.
Melinda works as a palliative care clinical nurse consultant. She has an interest in patients identified as socially complex at end of life.
Melinda has worked in community, subacute and acute care settings. Her last 8 years have been in palliative care.
She completed Post Graduate studies in 2024 and has continued work in the PCCS whilst undertaking an equity improvement project to ensure socially complex dying patients receive appropriate care in the acute context.
An advocate of mentoring and championing, she acknowledges the necessity of collaborating with multi-disciplinary teams.
Abstract:
Background:
Anecdotally, confidence in managing socially and medically complex patients at the end of life [EOL] in the acute setting is low. Social complexity as defined by the Australian Government department of Health indices refers to culturally and linguistically diverse backgrounds; Aboriginal and Torres Strait Islanders; index of relative socioeconomic advantage and disadvantage (IRSAD); homelessness; residential status and next-of-kin availability.
The Care Plan for the Dying Person Victoria [CPDP-V] embodies principles of best care and is reflective of National Palliative Care Standards and National Safety and Quality Standards. Locally CPDP-V guidelines are imbedded into policy and procedures; championing nurses is indicated to enhance implementation.
Aim:
To identify and support EOL care nurse champions on a general medicine floor of an acute hospital.
Method: –
1.Snap auditing of CPDP-V
2.EOLC nurse auditing
3.Replicable study day covering all domains of CPDP-V.
4.Fortnightly mentoring of identified nurse champions
5.Checklist development for identifying and ensuring domains of CPDP are acted upon.
6.Ward recognition of deaths as part of existing reporting.
Results:
Preliminary auditing of CPDP-V completion, demonstrated that of the 20 deaths: –
–11 were commenced on the CPDP-V
–6 had initial assessment completed.
Preliminary survey of nursing staff demonstrated of the 19 responses: –
–2 trained in communicating with patients and families at EOL.
–5 educated in dying recognition.
Study day Feedback: –
–Small group interactive education rated highly
–Practicing Communication in EOL care is essential
Conclusion:
Through the implementation of this project, it is anticipated a transition to a sustainable model of reframing existing palliative care consult service and ward nurse champion roles, for our socially complex dying patients will be achieved. It is anticipated that this project will add to existing structures and clinical processes.
58