Northampton Electronic Collection of Theses and Research

Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?

Ward, A., Graham, A. and Sixsmith, J. (2018) Does a 24/7 hospice at home service prevent or postpone acute hospital admissions? Poster presented to: Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference, Bournemouth, 15-16 March 2018.

Item Type: Conference or Workshop Item (Poster)
Abstract: Background. Most people wish to die at home but in England almost 50% die in hospital, suggesting that more can be done to keep people at home. Some studies have shown this may be possible, especially with adequate support and good pain control. Methods. Rennie Grove Hospice Care (RGHC) carried out an independent study to identify the value of their night team in providing 24/7 care over a period of 145 nights. The study considered whether the provision of overnight care affected decisions to make hospital admissions. Data from a night nurse template recording all overnight visits, a review of 42 patient/carer records of those who had called the night team, a carer questionnaire (n=87), carer interviews (n=18) and staff interviews (n=9), were analysed . Results. The night nurse template recorded 5 overnight admissions made during the study period, all for acute reasons and considered unavoidable. Review of 42 patient records showed 23 hospital/hospice admissions occurred, most during the daytime (18 to hospital, 5 to a hospice) of which only 3 were considered avoidable. The carer questionnaires showed 13 (16%) of their cared for persons had been admitted to hospital in the last few weeks of life, with most reporting the admission was necessary. Staff interviews identified a pride in supporting patients to stay at home, while information from carers gave a clear indication that RGHC nurses enabled their cared for individual to remain at home; that contact with the night team helped prevent or postpone an admission; and without RGHC their alternative would have been 111/999, district nurse or out-of-hours GP. Conclusions. There are occasions when hospital admission is appropriate. However, there was clear evidence showing support from the night team could prevent or postpone hospital admissions.
Subjects: R Medicine > R Medicine (General) > R726.8 Terminal care. Palliative medicine
Creators: Ward, Alison, Graham, Anne and Sixsmith, Judith
Corporate Creators: Rennie Grove Hospice Care
Faculties, Divisions and Institutes: University Faculties, Divisions and Research Centres - OLD > Research Centre > Institute of Health and Wellbeing
Research Centres > Centre for Health Sciences and Services
Date: 15 March 2018
Date Type: Publication
Event Title: Association for Palliative Medicine Supportive & Palliative Care (APM ASP) Conference
Event Dates: 15-16 March 2018
Event Location: Bournemouth
Event Type: Conference
Language: English
Status: Published / Disseminated
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