Health, Care or Voluntary Sector Role: Clinical Lead Specialist Palliative and End of Life Care
Supporting Organisation: Hertfordshire Community NHS Trust
I am a Specialist Palliative Care nurse by background with a passion for improving the experience of end of life care within the community setting. I currently job share the Clinical Lead for Specialist Palliative and End of Life Care for North Herts and Stevenage area.
Having recently completed an MSc in Healthcare Leadership, I wanted to continue the research I began for my dissertation, exploring a decision tool that promotes shared decision making with informal carers when considering the administration of anticipatory medication during last days of life care. This is an area of care that can be improved to give all concerned a better experience.
About Sarah's fellowship project
Title: Does using a decision aid tool support community nurses to adopt a shared decision-making approach with informal carers when using anticipatory medication during last days of life care?
There is a growing body of research that evidences the need to recognise and include informal carers more in last days of life care in the home setting. However, despite guidelines, there remains scant empirical research or evidence-based tools that provide a sound basis that supports clinicians to make shared decisions during the last days of life. This is pertinent to symptom control, as nurses are frequently called upon to administer anticipatory medicines to relieve distressing symptoms such as pain and agitation. The patient is often too unwell at this point to convey their own wishes and needs, instead relying on family members to act as advocates, sometimes with limited success. To help combat this problem, having consulted nurses from across my organisation, I devised a decision aid that promotes more shared decision making by asking patients screening questions about last days of life care ahead of need, as well as asking the patients permission to allow people important to them to advocate their needs when they are no longer able to. The decision aid has been positively received but its impact on care has yet to be determined and its implementation forms a central aspect of this fellowship application. The aim of my project is to explore whether the decision tool supports a shared decision making approach to administering anticipatory medication.
Sarah's Supervisor: Dr Ben Bowers, University of Cambridge
Contact Sarah: sarah.thompson47@nhs.net