Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design:...

Area of Science:

• Gerontology and Palliative Care
• Healthcare Management and Policy

Background:

• Global population aging necessitates enhanced palliative care for older adults.
• A significant proportion of deaths occur in nursing homes, highlighting the need for specialized palliative care in this setting.
• The World Health Organization (WHO) advocates for improved palliative care services for the elderly.

Purpose of the Study:

• To describe a model for an educational intervention aimed at implementing knowledge-based palliative care in nursing homes.
• To outline the design for evaluating the effectiveness of this knowledge-based palliative care implementation strategy.

Main Methods:

• A complex intervention evaluated using a cross-over design in 20 nursing homes across two counties.
• An educational program comprising five seminars over six months for staff and managers.
• Data collection involved quantitative (questionnaires, register data) and qualitative (interviews, observations) methods, with pre- and post-assessments in intervention and control groups.

Main Results:

• Feasibility testing was conducted through a pilot study in separate nursing homes prior to the main intervention.
• The evaluation included diverse stakeholders: older residents, next-of-kin, staff, and managers.
• Data collection is complete, and analysis is currently in progress.

Conclusions:

• The research will generate novel insights into implementing knowledge-based palliative care within nursing home environments.
• The study applies the Medical Research Council framework for complex interventions, integrating Development, Feasibility, Piloting, Evaluation, and Implementation stages.
• Findings will contribute to understanding change mechanisms crucial for effective palliative care implementation in an aging demographic.