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September 23-24, 2019 | Prague, Czech Republic
2
nd
International Conference on
Palliative Care
Clinical Trials and Pharmacovigilance
Joint Event
&
Background:
In the Netherlands district nurses and nurse
assistants have a pivotal role in palliative care at home.
Partly due to aging of society, an increase of palliative care is
expected. Related to this, we developed a guideline Palliative
Care at Home for district nurses and nurse assistants.
Methods:
This guideline is developed following the standard
of the Dutch AQUA-Advisory and Expert Group. To assess
the bottlenecks in daily practice, face to face and online
focus groups with district nurses and nurse assistants were
performed. Seven predefined questions were answered
by a systematic international literature review of existing
systematic literature reviews and evidence-based guidelines
in the field of palliative care at home. The AMSTAR and AGREE
II criteria were used to assess the methodological quality.
Results:
The 41 recommendations covered four themes:
support of self-management among patients; identification
of the palliative phase and needs assessment; advance
care planning and competences of district nurses and
nurse assistants. All four themes are structured as follows:
predefined questions, recommendations, results of the
literature review and other considerations. To obtain overall
agreement on each recommendation, all recommendations
were thoroughly discussed in the multidisciplinary project
group and advisory group with representatives of key
stakeholders in palliative care. This resulted in both
evidence-based and consensus-based recommendations.
Two examples of recommendations are: 1) District nurses
and nurse assistants plan patient centered palliative
care, taking into account the values, wishes, needs and
expectations of patients and those of their relatives, and 2)
District nurses and nurse assistants discuss the outcome of
the ’surprise question’ with the general practitioner if the
answer to that question is: 'No, I would not be surprised'.
Conclusions:
This guideline provide recommendations
concerning key aspects of palliative care at home by district
nurses and nurse assistants. They should serve as a reference
standard for providing palliative nursing care and for
collaboration with the interdisciplinary team around patients,
in particular with the general practitioner.
Speaker Biography
Els M L Verschuur has a background in nursing. She is a Bachelor Nurse (not
practicing) and studied Nursing Sciences at the University of Utrecht, The
Netherlands. She has completed her PhD in 2007 from Erasmus University
Medical Center, The Netherlands. She has over 50 publications and is
serving as an editorial member of the Dutch Flemish Scientific Journal
‘Verpleegkunde’. She is a member of Sigma Theta Tau at Large chapter Rho
Chi. She is working at HAN University of Applied Sciences in Nijmegen The
Netherlands as a Lecturer Advisor and Senior Researcher.
e:
Els.Verschuur@han.nlEls M L Verschuur
1
van der Sande R
1
and
Francke A L
2
1
HAN University of Applied Sciences, The Netherlands
2
Nivel, Utrecht & Amsterdam UMC, The Netherlands
Palliative care in a home care setting; the development of a
guideline for district nurses and nurse assistants
Journal of Primary Care and General Practice | Volume 2
J Prim Care Gen Pract, Volume:2