Table 3 Overview of the components within the implementation guide for the acute geriatric ward
Components | Source* |
|---|---|
Component 1-Establishing the implementation project and preparing the environment | |
❖ Informing the health care staff caring for older hospitalized patients about the implementation project and the importance of change in care during the last days of life | 1 |
❖ Executive endorsement: acquiring management approval for the trainings and audits | |
❖ Involvement of specialist palliative care services is recommended: at least one member of the Palliative Support Team of the hospital is member of the steering group | 1 |
1 | |
❖ Facilitators: a nurse and a physician of the geriatric ward | 1, 2 |
❖ Formation of steering group: at least four people of the geriatric ward (facilitators included) | 1 |
❖ Intensive 2-day training of facilitators | 1, 2 |
Component 2-Preparing the documentation | |
1. Development of an information leaflet for family carers about the facilities in the geriatric ward | 1 |
Component 3-Baseline review | |
1. Analyzing end-of-life care data of deceased older hospitalized patients using the patients’ medical files | 1, 2 |
2. Feedback of the results to the staff and focusing on improvement within the geriatric ward | |
Component 4-Training health care staff caring for older hospitalized patients | |
1. Facilitators and specialist palliative care colleagues train health care staff with the aid of a training package (i.e. hand-outs with information about the Care Guide, a copy of the Care Guide, a casus to discuss in group etc.) | 1, 2 |
2. Aim training | 1, 2 |
○ To understand and work with the Care Guide | |
Component 5-Care Guide use and intensive support | |
1. Care Guide use after sufficient training and education | 1, 2 |
2. Intensive support and supervision by the steering group through repeated coaching, telephone, and direct guidance, discussion of clinical cases, and clinical audits | 1, 2 |
Component 6-Semi-intensive support | |
1. Semi-intensive support and supervision by the steering group through repeated coaching, telephone, and direct guidance, discussion of clinical cases, and clinical audits | 1, 2 |
Component 7-Evaluation | |
1. To organize a qualitative evaluation of the implementation: evaluating and discussing the performance and progress of each of the previous components | 1, 2 |
2. The qualitative evaluation acknowledges areas where further support, education, or training is need | 1 |
Component 8-Consolidation | |
1. To adopt a strategy to maintain/improve the implementation and sustainability of the Care Guide | 1 |
2. Support and supervision by the steering group through repeated coaching, telephone, and direct guidance, discussion of clinical cases, and clinical audits | 1, 2 |
Component 9-Ongoing education, training, and support | |
1. Keeping up to date with developments in end-of-life care and a continuing education and evaluation within the hospital ward |