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Implementation and evaluation of a palliative and end-of-life care peer-learning initiative

25 February 2021
Volume 30 · Issue 4



Palliative and end-of-life care skills for nurses in acute care are dependent on the level of training received. Hospices are seen as fountains of knowledge in end-of-life and complex care issues.


This study evaluated peer learning between registered nurses (RNs) at West Suffolk Foundation Trust and St Nicholas Hospice Care. Six acute and six hospice nurses spent 1 week each, over a 6-month period, shadowing in the opposite of their usual acute or hospice setting.


The study used an action research approach. Reflective diaries, questionnaires and evaluation forms provided feedback, giving nursing practice perspectives on learning gained during the shadowing process.


Key features were improved knowledge in medications for symptom management in end of life; understanding holistic assessments to enhance patient care; key competencies completed.


This study led to the development of the West Suffolk Foundation Trust 2-day shadowing model offering access to end-of-life care learning.

Palliative care aims to improve quality of life for patients with a life-limiting illness through relief from pain and other symptoms. It neither hastens nor postpones death and integrates the psychological and spiritual aspects of patient care (World Health Organization (WHO), 2020). End-of-life care involves the treatment, care and support for people who are nearing the end of their life and is part of palliative care (Marie Curie, 2018).

The author, a member of the palliative care team at West Suffolk NHS Foundation Trust (WSFT), took up a Macmillan Educator post, sponsored by Macmillan, originally as a 2-year end-of-life education nurse project. The author developed a WSFT Integrated Learning in Palliative Care (ILPC) model. As part of this, a research study was organised, comprising 1-week shadow placements between services for six registered nurses (RNs) based at WSFT's Macmillan unit and six RNs based at St Nicholas Hospice Care's (SNHC) Sylvan ward. The hospice is situated within the hospital grounds in Bury St Edmunds, although separate from the main hospital. The primary aim of the study was to evaluate a peer-learning initiative for RNs working in both acute wards and palliative care settings. An action research approach was used, which allowed the RNs taking part to give feedback from their own nursing practice perspective, when working with palliative care patients and those requiring end-of-life care. This article focuses primarily on the evaluation of end-of-life care practice.

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