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Start Over Author "Piers, Ruth" Journal bmc palliative care
4 results on '"Piers, Ruth"'

3. Large differences in the organization of palliative care in nursing homes in six European countries: findings from the PACE cross-sectional study.

Author

Honinx, E., Van den Block, L., Piers, R., Onwuteaka-Philipsen, B. D., Payne, S., Szczerbińska, K., Gambassi, G., Kylänen, M., Deliens, L., Smets, T., on behalf of PACE, Gatsolaeva, Yuliana, Miranda, Rose, Pivodic, Lara, Tanghe, Marc, van Hout, Hein, Pasman, Roeline H. R. W., Oosterveld-Vlug, Mariska, Piers, Ruth, and Wichmann, Anne B.

Subjects
MEDICAL quality control, MEETINGS, HEALTH services administration, HEALTH services accessibility, MEDICAL care, NURSING care facilities, QUALITY assurance, HEALTH care teams, DESCRIPTIVE statistics, CHI-squared test, QUESTIONNAIRES, STATISTICAL sampling, STATISTICAL correlation, PALLIATIVE treatment, SECONDARY analysis
Abstract

Background: To be able to provide high-quality palliative care, there need to be a number of organizational structures available in the nursing homes. It is unclear to what extent such structures are actually present in nursing homes in Europe. We aim to examine structural indicators for quality of palliative care in nursing homes in Europe and to evaluate the differences in terms of availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. Methods: A PACE cross-sectional study (2015) of nursing homes in Belgium, England, Finland, Italy, the Netherlands and Poland. Nursing homes (N = 322) were selected in each country via proportional stratified random sampling. Nursing home administrators (N = 305) filled in structured questionnaires on nursing home characteristics. Organization of palliative care was measured using 13 of the previously defined IMPACT structural indicators for quality of palliative care covering four domains: availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. We calculated structural indicator scores for each country and computed differences in indicator scores between the six countries. Pearson's Chi-square test was used to compute the p-value of each difference. Results: The availability of specialist palliative care teams in nursing homes was limited (6.1–48.7%). In Finland, Poland and Italy, specialist advice was also less often available (35.6–46.9%). Up to 49% of the nursing homes did not provide a dedicated contact person who maintained regular contact with the resident and relatives. The 24/7 availability of opioids for all nursing home residents was low in Poland (37.5%). Conclusions: This study found a large heterogeneity between countries in the organization of palliative care in nursing homes, although a common challenge is ensuring sufficient structural access to specialist palliative care services. Policymakers and health and palliative care organizations can use these structural indicators to identify areas for improvement in the organization of palliative care. [ABSTRACT FROM AUTHOR]

Published
2021
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4. Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the ‘PACE Steps to Success’ intervention in seven countries

Author

Smets, Tinne, Onwuteaka-Philipsen, Bregje B. D., Miranda, Rose, Pivodic, Lara, Tanghe, Marc, van Hout, Hein, Pasman, Roeline H. R. W., Oosterveld-Vlug, Mariska, Piers, Ruth, van den Noortgate, Nele, Wichmann, Anne B., Engels, Yvonne, Vernooij-Dassen, Myrra, Hockley, Jo, Froggatt, Katherine, Payne, Sheila, Szczerbińska, Katarzyna, Kylänen, Marika, Leppäaho, Suvi, Barańska, Ilona, Gambassi, Giovanni, Pautex, Sophie, Bassal, Catherine, Deliens, Luc, van den Block, Lieve, Mammarella, Federica, Mercuri, Martina, Rossi, Paola, Segat, Ivan, Stodolska, Agata, Adang, Eddy, Andreasen, Paula, Kuitunen-Kaija, Outi, Moore, Danni Collingridge, Pac, Agnieszka, Kijowska, Violetta, ten Koppel, Maud, van der Steen, Jenny T., de Paula, Emilie Morgan, VU University medical center, General practice, Public and occupational health, APH - Aging & Later Life, APH - Quality of Care, Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, End-of-life Care Research Group, and Clinical sciences

Subjects
Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1], Palliative care, Quality management, law.invention, Study Protocol, Indirect costs, 0302 clinical medicine, Belgium, Randomized controlled trial, law, Surveys and Questionnaires, Health care, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Cluster randomised controlled trial, Finland, SCALE, Netherlands, Medicine(all), Nursing home, lcsh:RC952-1245, General Medicine, 3. Good health, England, Italy, End-of-life care, 030220 oncology & carcinogenesis, END, Switzerland, RESIDENTS, lcsh:Special situations and conditions, Care home, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, Nursing, Humans, QUALITY, KNOWLEDGE, VALIDITY, Quality improvement, Skilled Nursing Facilities, HOMES, business.industry, Settore MED/09 - MEDICINA INTERNA, ADVANCED DEMENTIA, Long-term care, ddc:618.97, Poland, OF-LIFE CARE, business, Delivery of Health Care
Abstract

Background: Several studies have highlighted the need for improvement in palliative care delivered to older people long-term care facilities. However, the available evidence on how to improve palliative care in these settings is weak, especially in Europe. We describe the protocol of the PACE trial aimed to 1) evaluate the effectiveness and cost-effectiveness of the 'PACE Steps to Success' palliative care intervention for older people in long-term care facilities, and 2) assess the implementation process and identify facilitators and barriers for implementation in different countries.Methods: We will conduct a multi-facility cluster randomised controlled trial in Belgium, Finland, Italy, the Netherlands, Poland, Switzerland and England. In total, 72 facilities will be randomized to receive the 'Pace Steps to Success intervention' or to 'care as usual'. Primary outcome at resident level: quality of dying (CAD-EOLD); and at staff level: staff knowledge of palliative care (Palliative Care Survey). Secondary outcomes: resident's quality of end-of-life care, staff self-efficacy, self-perceived educational needs, and opinions on palliative care. Economic outcomes: direct costs and quality-adjusted life years (QALYs).Measurements are performed at baseline and after the intervention. For the resident-level outcomes, facilities report all deaths of residents in and outside the facilities over a previous four-month period and structured questionnaires are sent to (1) the administrator, (2) staff member most involved in care (3) treating general practitioner, and (4) a relative. For the staff-level outcomes, all staff who are working in the facilities are asked to complete a structured questionnaire. A process evaluation will run alongside the effectiveness evaluation in the intervention group using the RE-AIM framework.Discussion: The lack of high quality trials in palliative care has been recognized throughout the field of palliative care research. This cross-national cluster RCT designed to evaluate the impact of the palliative care intervention for long-term care facilities 'PACE Steps to Success' in seven countries, will provide important evidence concerning the effectiveness as well as the preconditions for optimal implementation of palliative care in nursing homes, and this within different health care systems.Trial registration: The study is registered at www.isrctn.com – ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) Registration date: July 30, 2015.

Published
2018

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