Table 1 Components of the SHARE model (Frey et al., 2017)

Records Review

The identification of residents who would benefit from a palliative approach was completed through a records review conducted by the hospice palliative care nurse specialist in conjunction with a registered nurse (RN) from each facility. The review included an assessment of resident palliative care need using the Supportive Palliative Care Indicators Tool [31] and the Clinical Frailty Scale [32]. The purpose of the review was to provide the basis for ongoing monitoring of resident palliative care need and to create a “Goals of Care” plan for those on the registry.

Clinical Coaching and Role Modelling

This was a reciprocal process of shared learning between palliative care nurse specialists and long-term care RN’s and healthcare assistants (HCA’s). In partnership with HCA’s, RN’s and General Practitioners (GP) the palliative care nurse specialists worked to develop and update a “Goals of Care” plan to reflect new or changing palliative care needs. This consultation was made in partnership with the RN and HCA present to provide opportunities for clinical coaching, role modelling and development of clinical knowledge.

Palliative Care Education Planning

The palliative care nurse specialist worked together with RN’s and HCA’s to discuss the specific learning needs in each facility identifying the priorities for staff. A programme of education was be developed that was unique to that facility and complimented the current education provided by the two hospices.

Debriefing

Debriefing following resident deaths was offered facilitated by the palliative care nurse specialist in collaboration with a senior RN from the facility. This service provided an opportunity to acknowledge the emotional impact of end of life care. It also provided an opportunity to reflect on the care provided.