10 results on '"Hockley, Jo"'
Search Results
2. A framework for cross-cultural development and implementation of complex interventions to improve palliative care in nursing homes: the PACE steps to success programme
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Hockley, Jo, Froggatt, Katherine, Van Den Block, Lieve, Onwuteaka-Philipsen, Bregje, Kylänen, Marika, Szczerbińska, Katarzyna, Gambassi, Giovanni, Pautex, Sophie, Payne, Sheila Alison, Arrue, Borja, Baranska, Ilona, Deliens, Luc, Engels, Yvonne, Finne-Soveri, Harriet, Kijowska, Viola, Ten Koppel, Maud, Mammarella, Federica, Smets, Tinne, Oosterveld-Vlug, Mariska, Pasman, Roeline, Piers, Ruth, Pivodic, Lara, Van Der Steen, Jenny, Van Den Noortgate, Nele, Van Hout, Hein, Wichmann, Anne, Vernooij-Dassen, Myrra, End-of-life Care Research Group, Clinical sciences, Public and occupational health, APH - Aging & Later Life, APH - Quality of Care, and General practice
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Cross-Cultural Comparison ,Palliative care ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,GOLD STANDARDS FRAMEWORK ,education ,Psychological intervention ,Social Sciences ,Intervention ,Development ,Health informatics ,Health administration ,PATHWAY ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Medicine and Health Sciences ,Medicine ,Humans ,030212 general & internal medicine ,Pace ,Medical education ,Terminal Care ,Cross-cultural adaptation ,BARRIERS ,business.industry ,Long-term care facilities ,Nursing home ,4. Education ,030503 health policy & services ,Health Policy ,Nursing research ,lcsh:Public aspects of medicine ,lcsh:RA1-1270 ,Long-Term Care ,Quality Improvement ,Nursing Homes ,Europe ,End-of-life care ,Implementation ,ddc:618.97 ,OF-LIFE CARE ,0305 other medical science ,business ,Research Article - Abstract
Background The PACE Steps to Success programme is a complex educational and development intervention to improve palliative care in nursing homes. Little research has investigated processes in the cross-cultural adaptation and implementation of interventions in palliative care across countries, taking account of differences in health and social care systems, legal and regulatory policies, and cultural norms. This paper describes a framework for the cross-cultural development and support necessary to implement such an intervention, taking the PACE Steps to Success programme as an exemplar. Methods The PACE Steps to Success programme was implemented as part of the PACE cluster randomised control trial in seven European countries. A three stage approach was used, a) preparation of resources; b) training in the intervention using a train-the-trainers model; and c) cascading support throughout the implementation. All stages were underpinned by cross-cultural adaptation, including recognising legal and cultural norms, sensitivities and languages. This paper draws upon collated evidence from minutes of international meetings, evaluations of training delivered, interviews with those delivering the intervention in nursing homes and providing and/or receiving support. Results Seventy eight nursing homes participated in the trial, with half randomized to receive the intervention, 3638 nurses/care assistants were identified at baseline. In each country, 1–3 trainers were selected (total n = 16) to deliver the intervention. A framework was used to guide the cross-cultural adaptation and implementation. Adaptation of three English training resources for different groups of staff consisted of simplification of content, identification of validated implementation tools, a review in 2 nursing homes in each country, and translation into local languages. The same training was provided to all country trainers who cascaded it into intervention nursing homes in local languages, and facilitated it via in-house PACE coordinators. Support was cascaded from country trainers to staff implementing the intervention. Conclusions There is little guidance on how to adapt complex interventions developed in one country and language to international contexts. This framework for cross-cultural adaptation and implementation of a complex educational and development intervention may be useful to others seeking to transfer quality improvement initiatives in other contexts.
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- 2019
3. Strategies for the implementation of palliative care education and organizational interventions in long-term care facilities: A scoping review.
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Collingridge Moore, Danni, Payne, Sheila, Van den Block, Lieve, Ling, Julie, Froggatt, Katherine, Gatsolaeva, Yuliana, Honinx, Elisabeth, Pivodic, Lara, Miranda, Rose, Onwuteaka-Philipsen, Bregje D., van Hout, Hein, Pasman, H. Roeline W., Oosterveld-Vlug, Mariska, Ten Koppel, Maud, Piers, Ruth, Van Den Noortgate, Nele, Engels, Yvonne, Vernooij-Dassen, Myrra, Hockley, Jo, and Szczerbińska, Katarzyna
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CINAHL database ,HEALTH services accessibility ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,INTEGRATED health care delivery ,LONG-term health care ,MEDICAL practice ,MEDLINE ,PALLIATIVE treatment ,STRATEGIC planning ,SYSTEMATIC reviews - Abstract
Background: The number of older people dying in long-term care facilities is increasing; however, care at the end of life can be suboptimal. Interventions to improve palliative care delivery within these settings have been shown to be effective in improving care, but little is known about their implementation. Aim: The aim of this study was to describe the nature of implementation strategies and to identify facilitators and/or barriers to implementing palliative care interventions in long-term care facilities. Design: Scoping review with a thematic synthesis, following the ENTREQ guidelines. Data sources: Published literature was identified from electronic databases, including MEDLINE, EMBASE, PsycINFO and CINAHL. Controlled, non-controlled and qualitative studies and evaluations of interventions to improve palliative care in long-term care facilities were included. Studies that met the inclusion criteria were sourced and data extracted on the study characteristics, the implementation of the intervention, and facilitators and/or barriers to implementation. Results: The review identified 8902 abstracts, from which 61 studies were included in the review. A matrix of implementation was developed with four implementation strategies (facilitation, education/training, internal engagement and external engagement) and three implementation stages (conditions to introduce the intervention, embedding the intervention within day-to-day practice and sustaining ongoing change). Conclusion: Incorporating an implementation strategy into the development and delivery of an intervention is integral in embedding change in practice. The review has shown that the four implementation strategies identified varied considerably across interventions; however, similar facilitators and barriers were encountered across the studies identified. Further research is needed to understand the extent to which different implementation strategies can facilitate the uptake of palliative care interventions in long-term care facilities. [ABSTRACT FROM AUTHOR]
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- 2020
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4. Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework.
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Oosterveld-Vlug, Mariska, Onwuteaka-Philipsen, Bregje, ten Koppel, Maud, van Hout, Hein, Smets, Tinne, Pivodic, Lara, Tanghe, Marc, Van Den Noortgate, Nele, Hockley, Jo, Payne, Sheila, Moore, Danni Collingridge, Kijowska, Violetta, Szczerbińska, Katarzyna, Kylänen, Marika, Leppäaho, Suvi, Mercuri, Claudia, Rossi, Paola, Mercuri, Martina, Gambassi, Giovanni, and Bassal, Catherine
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LONG-term care facilities ,INTERNET forums ,CLUSTER randomized controlled trials - Abstract
Background: The PACE 'Steps to Success' programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, this programme has been implemented in 37 LTCFs in 7 European countries. Alongside an effectiveness study, a process evaluation study was conducted. This paper reports on the results of this process evaluation, of which the aim was to provide a more detailed understanding of the implementation of the PACE Programme across and within countries.Methods: The process evaluation followed the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and involved various measures and tools, including diaries for country trainers, evaluation questionnaires for care staff, attendance lists and interviews (online and face-to-face, individual and in groups) with country trainers, managers, PACE coordinators and other staff members. Based on key elements of the PACE Programme, a priori criteria for a high, medium and low level of the RE-AIM components Reach, Adoption, Implementation and intention to Maintenance were defined. Qualitative data on factors affecting each RE-AIM component gathered in the online discussion groups and interviews were analysed according to the principles of thematic analysis.Results: The performance of the PACE Programme on the RE-AIM components was highly variable within and across countries, with a high or medium score for in total 28 (out of 37) LTCFs on Reach, for 26 LTCFs on Adoption, for 35 LTCFs on Implementation and for 34 LTCFs on intention to Maintenance. The factors affecting performance on the different RE-AIM components could be classified into three major categories: (1) the PACE Programme itself and its way of delivery, (2) people working with the PACE Programme and (3) contextual factors. Several country-specific challenges in implementing the PACE Programme were identified.Conclusions: The implementation of the PACE Programme was feasible but leaves room for improvement. Our analysis helps to better understand the optimal levels of training and facilitation and provides recommendations to improve implementation in the LTC setting. The results of the process evaluation will be used to further adapt and improve the PACE Programme prior to its further dissemination.Trial Registration: The PACE study was registered at www.isrctn.com-ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) July 30, 2015. [ABSTRACT FROM AUTHOR]- Published
- 2019
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5. A practice development initiative supporting care home staff deliver high quality end-of-life care.
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Hockley, Jo
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AUDITING , *BENCHMARKING (Management) , *CARDIOPULMONARY resuscitation , *DO-not-resuscitate orders , *DOCUMENTATION , *FRAIL elderly , *GERIATRIC nursing , *HOSPICE care , *HOSPITAL care , *INTERPROFESSIONAL relations , *LONG-term health care , *EVALUATION of medical care , *MORTALITY , *NURSING home patients , *NURSING care facility administration , *NURSING home employees , *PERSONNEL management , *QUALITY assurance , *TERMINAL care , *TERMINALLY ill , *ADVANCE directives (Medical care) , *PROFESSIONAL practice , *CHANGE management , *HUMAN services programs , *ACCREDITATION , *DESCRIPTIVE statistics - Abstract
Background: The global population is changing with an increasing percentage of the oldest old, many of whom in the UK are looked after in care homes. Care homes now provide care for a fifth of the UK population who die each year. However, most nursing care homes are privately owned and not part of the NHS, which exposes staff to a lack of skills/knowledge in relation to end-of-life care. Methods: To implement the Gold Standards Framework in Care Homes Programme and audit outcomes within nursing care homes across five Clinical Commissioning Groups over a 7-year period using a research-based model of facilitation. Results: The percentage of residents dying in nursing care homes increased from 57% to 79%, with improvement in other outcomes. Conclusions: A 'high' facilitation model, including a sustainability initiative and ongoing audit, contributed to significant improvements when implementing the Programme. Reciprocity and trustworthiness underpin the success of this initiative. [ABSTRACT FROM AUTHOR]
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- 2016
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6. The effect of using high facilitation when implementing the Gold Standards Framework in Care Homes programme: A cluster randomised controlled trial.
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Kinley, Julie, Stone, Louisa, Dewey, Michael, Levy, Jean, Stewart, Robert, McCrone, Paul, Sykes, Nigel, Hansford, Penny, Begum, Aysha, and Hockley, Jo
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CONFIDENCE intervals ,MEDICAL quality control ,NURSE administrators ,NURSING care facilities ,QUALITY assurance ,QUESTIONNAIRES ,RESEARCH funding ,TERMINAL care ,LOGISTIC regression analysis ,RANDOMIZED controlled trials ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
The article presents information on the effect of using high facilitation while implementing the Gold Standards Framework in Care Homes programme in Great Britain. It was hypothesised that implementing the programme will help in reducing hospital deaths for residents. It is concluded that without national guidelines, facilitation of the programme will vary and its implementation.
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- 2014
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7. IMPLEMENTING STOCK END-OF-LIFE MEDICATION IN UK NURSING HOMES.
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Morris, Kathy and Hockley, Jo
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NURSING audit ,NURSING care facilities ,AUDIT trails ,DRUG therapy ,FRAIL elderly ,MORTALITY ,NURSE administrators ,PALLIATIVE treatment ,QUALITY assurance ,QUESTIONNAIRES ,TERMINALLY ill ,EVALUATION of human services programs - Abstract
Background: In nursing care homes (NCHs), the use of end-of-life care (EoLC) medication has traditionally been requested and prescribed on an individual basis during each resident's last days of life. However, some GPs are reluctant to prescribe EoLC medication in anticipation of symptoms occurring if, at the time of their visit, the resident is symptom-free. Even when prescribed, care home staff can experience difficulties obtaining the medication out of hours. This can result in residents not having access to appropriate medications when they are experiencing symptoms. Aim: This audit aimed to assess the feasibility of NCHs with Gold Standards Framework in Care Homes (GSFCH) accreditation keeping EoLC medications 'as stock', rather than having the medication prescribed and dispensed for individual residents when residents became symptomatic. Methods: Meetings were held with nurse managers of four NCHs with GSFCH accreditation, local pharmacists and the hospice pharmacist. A strategy to implement the stock medication was prepared. A baseline review of the notes of deceased residents 6 months pre-implementation was undertaken and information regarding symptoms and EoLC medication extracted. The review continued for 6 months after the stock EoLC medication was obtained. Results: Three NCHs participated. The notes of 92 deceased residents were examined. Fifty-three per cent of decedents were found to have experienced common EoLC symptoms. The numbers with access to EoLC medication increased once the stock medication was in place. However, some residents still had their own drugs dispensed, despite stock drugs being available. Conclusions: There is a need for all dying residents to have access to EoLC medication. The proper facilitation and implementation of EoLC medication 'as stock' into NCHs with expertise in caring for dying people could save monies at a time of NHS austerity measures. If the NCHs had relied solely on the stock medication, the reduction in medication waste would have been significant. The introduction of stock medication would also solve problems associated with obtaining medication out of hours. Conflicts of interest: none [ABSTRACT FROM AUTHOR]
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- 2013
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8. A baseline review of medication provided to older people in nursing care homes in the last month of life.
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Kinley, Julie and Hockley, Jo
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NURSING care facilities , *TERMINAL care , *MEDICAL care for older people , *ELDER care , *LONG-term care facilities - Abstract
Aim: Increasing numbers of older people are dying in the nursing care home setting. Little is known about the medication needs of the very old and frail in the last weeks of life and how they might differ from a model of care developed for people dying from cancer. Method: A baseline review of medication in the last month of life was undertaken to try and establish current practice of prescribing for this population. The notes of 48 deceased residents in seven nursing care homes were examined, alongside a questionnaire sent to 67 trained nurses. Results: Subcutaneous prescribing only occurred where specialist palliative care teams had been involved with the residents' care. Syringe drivers were used in 23% of cases; however, only three residents required a syringe driver for more than a day and a half. Nurses' confidence and competence in setting up syringe drivers was varied. Conclusions: The use of syringe drivers may not be the most appropriate way of managing symptoms during the dying phase in very frail and old people. [ABSTRACT FROM AUTHOR]
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- 2010
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9. Barriers to implementing an integrated care pathway for the last days of life in nursing homes.
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Watson, Julie, Hockley, Jo, and Dewar, Belinda
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INTEGRATED health care delivery , *TERMINAL care , *NURSING care facilities , *LONG-term health care , *MEDICAL care for older people , *PALLIATIVE treatment , *REHABILITATION nursing , *LONG-term care facilities - Abstract
Aim:This paper explores the barriers that needed to be overcome during the process of implementing an integrated care pathway for the last days of life as a way of developing quality end-of-life care in nursing homes. Methods: An action research methodology underpinned the study. Qualitative and quantitative data were collected in eight nursing homes before, during and after the implementation of the care pathway. Findings: Six main barriers were identified: a lack of knowledge of palliative care drugs and control of symptoms at the end of life; lack of preparation for approaching death; not knowing when someone is dying or understanding the dying process; lack of multidisciplinary team working in nursing homes; lack of confidence in communicating about dying; some nursing homes are not ready or able to change. These findings highlight a functional `rehabilitative' culture that may not be so appropriate in the current context of nursing home care, and one that makes implementing an integrated care pathway for the last days of life less straightforward than in other settings. Conclusion: It cannot be presumed that the implementation of a care pathway for the last days of life in nursing homes is straightforward. This study suggests that an action research framework was extremely useful in highlighting and overcoming some obstacles when developing evidence-based practice. Action at both local and public policy level is required to fully address barriers that prevent quality end-of-life care in nursing homes. [ABSTRACT FROM AUTHOR]
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- 2006
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10. Promoting end-of-life care in nursing homes using an ‘integrated care pathway for the last days of life’.
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Hockley, Jo, Dewar, Belinda, and Watson, Julie
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The purpose of this study was to promote quality end-of-life care in eight independent nursing homes using an ‘integrated care pathway (ICP) for the last days of life’ document. Action research methodology underpinned the design of this study in order to promote collaboration between staff in the nursing homes and the research team, empower staff in the practice of quality end-of-life care, and promote sustainable development of end-of-life care once the study finished. Considerable barriers within the nursing home context highlighted initial difficulties. This is reported elsewhere (Watson et al., in press) (Bridges Initiative, 2004). However, key champions appointed in each nursing home and their subsequent support was a major part of facilitating the ICP implementation. This paper reports the qualitative analysis from the summative evaluation of the study. One overarching pattern of ‘dying being more central to care in the nursing homes’ emerged as a result of the study; five themes that contributed to this shift were: greater ‘openness’ around death and dying; recognising dying and taking responsibility; better ‘teamwork’; critically using palliative care knowledge to influence practice; more meaningful communication. [ABSTRACT FROM PUBLISHER]
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- 2005
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