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Palliative Care

The impact of in-house education on staff confidence in delivering palliative and end-of-life care: a service evaluation

07 November 2024
Professional
02 November 2024
Volume 33 · Issue 20

Abstract

Background:

Palliative and end-of-life care (EoLC) education is available to all community and hospital healthcare staff in one NHS trust in the north-east of England. It is also available to care home and domiciliary care staff within the geographical area of the trust.

Aims:

This service evaluation assessed the effect of current in-house education on staff confidence levels in delivering palliative and EoLC. It also examined staff perceptions of how attendance at these courses impacted on the palliative and EoLC patients receive across the locality.

Method:

A mixed-methods approach was undertaken. Anonymous data were collected via surveys (n=238) sent out in March 2023 covering educational courses that were delivered from 1 January to 31 December 2022 with a 13% response rate. Quantitative data were analysed using descriptive statistics. Qualitative data were explored using Braun and Clarke's (2012) six-stage approach to thematic analysis. A second staff member was asked to review the data to increase the trustworthiness of the study.

Findings:

Staff confidence levels in delivering palliative and EoLC increased by 19% (somewhat confident) and 23% (extremely confident) following attendance at trust education. Staff perceived that those patients received better palliative and EoLC as a result their attendance at these courses. The qualitative data identified five main themes: symptom control, psychological support, holistic care, patient advocacy, and advance care planning. Limitations of the study included the low survey response rate and lack of exploration of patient/carer perceptions directly.

Conclusion:

Palliative and EoLC education can increase staff confidence levels in care delivery and, as perceived by staff, results in better care for patients receiving palliative and EoLC. These findings provide evidence for the trust to consider making palliative and EoLC training mandatory, which could also be considered more widely regionally and nationally.

All patients with advanced, progressive and life-limiting illness should receive the best possible care throughout their palliative diagnosis and into death, regardless of where they live and die. There is a plethora of national guidance that supports the fundamental requirement for all staff to have the knowledge and skills to competently deliver high-quality palliative and end-of-life care (EoLC) regardless of where the patient is cared for (Department of Health (DH), 2008; Leadership Alliance for the Care of Dying People 2014; Healthcare Quality Improvement Partnership, 2019; National Palliative and End of Life Care Partnership, 2021). However, Cicely Saunders International (2021) identified that only 10% of nurses felt prepared to deliver good palliative and EoLC. One reason for this was lack of education.

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Palliative care
End-of-life care
Staff confidence
Patient care
Education