Facing uncertainty - Pilot testing of a palliative prognostic index training with hospital aged care assessment teams.

2023-10-13

Gerber, Katrin

Bloomer, Melissa J

Hayes, Barbara

Lee, Cik Yin

Lock, Kayla

Bodna, Karen

Yates, Paul A

Aged

Death

Decision making

Dying

End-of-life care

Hospital care

Nursing

Palliative care

Qualitative research methods

Quantitative research methods

Residential aged care

recognition of dying

Journal Article

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10.1016/j.gerinurse.2023.09.014

Prognostic avoidance can delay discussions about older hospital patients' life expectancy. This pilot study examined the effects of a prognostic training program on hospital clinicians' knowledge and confidence in identifying older patients at risk of dying. Fifty-seven clinicians from aged care assessment teams at two Australian hospitals were introduced to the Palliative Prognostic Index, a 5-item checklist indicating prognoses between 3 and 6 weeks. Mixed-methods training evaluation included pre-post-training surveys and semi-structured interviews, conducted three months post-training. Clinicians used a combination of experience, knowledge, and intuition as strategies to generate prognoses. Allied health staff relied on intuition more often than medical and nursing staff. Prognostic tools were rarely used. Pre-post-training comparisons showed significant improvements in clinicians' knowledge and confidence in identifying signs of dying, particularly amongst allied health. Follow-up interviews highlighted advantages and challenges of using prognostic tools. Recommendations are made for addressing these.

link

Geriatric Nursing (New York, N.Y.) 2023-10-13; 54

Geriatric Nursing (New York, N.Y.)

1528-3984