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Developing palliative care practice guidelines and standards for nursing home-based palliative care teams: a Delphi
Helena Temkin-Greener1, Susan Ladwig2, Tom Caprio2
1Department of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY.
Journal of the American Medical Directors Association
|December 8, 2014
Summary
Nursing homes can improve palliative care by implementing 17 key guidelines and establishing core palliative care teams. This study identified important and feasible practices for end-of-life care in these settings.
Area of Science:
- Gerontology
- Palliative Care
- Healthcare Management
Background:
- Lack of specific palliative care guidelines hinders quality end-of-life (EOL) care in nursing homes (NHs).
- Addressing this gap is crucial for improving resident care and support.
Purpose of the Study:
- To determine the importance and feasibility of National Consensus Project guidelines and National Quality Forum preferred practices for NH palliative care.
- To define operational standards for palliative care teams within NHs.
Main Methods:
- A two-round mail Delphi study involving 48 NH leaders and clinicians.
- Participants rated the importance and feasibility of 22 drafted palliative care guidelines.
- Palliative care team composition and rounding frequency were also assessed.
Main Results:
- A high response rate of 85% was achieved across both Delphi rounds.
- 17 palliative care guidelines were identified as suitable for NH implementation.
- A core palliative care team comprising social work, certified nurse assistant, nurse, physician, and nurse practitioner/physician assistant was defined.
Conclusions:
- The identified palliative care guidelines and team standards offer practical direction for NHs.
- Implementation can enhance palliative care practices and improve EOL quality for residents.
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