End-of-Life Essentials: Increasing professionals’ skills and confidence in end-of-life care

Kim Devery leads a major national education and knowledge translation project End-of-Life Essentials. It’s free and evidence based, and aims to increase professionals’ skills and confidence in end-of-life care in Australian acute hospitals.

Kim Devery.

In many developed regions of the world, populations are ageing, and incidences of chronic complex illnesses are increasing.  In developed countries like Australia, heart, lung, vascular and cancer illnesses, plus dementia, are leading causes of death. (1) People live with these chronic conditions for many years before death. These illnesses, while not curable, can be managed and patients’ lives prolonged for some time as mortality data show.(2) Most Australians live a very long life and then die in hospitals. (3)  Many clinicians who work in hospitals have had little training in end-of-life care.(4)

Hospitals continue to be the place where people go to when health crisis occurs.

Doctors, nurses and allied health professionals who work in hospitals are increasingly required to provide care and service to older people with complex needs who may be at the end of life. Balancing treatment of end-stage chronic complex conditions with identification of, and preparation for, the end of life are the skills in which many healthcare professionals are inadequately educated. Hospital systems and clinicians have become so wonderfully skilled at treating chronic complex illness and prolonging life, that entering into discussions about the inevitable end of life or dying may seem rather superfluous. However, we will all die. For professionals, learning how to begin conversations about future care needs and likely prognosis is key – along with effective teamwork, recognising and responding to suffering, and compassionate care when death is imminent.

Knowing when and how to introduce and discuss end-of-life issues and concerns can be a challenge. Being prepared is vital. Responding to national needs, End-of-Life Essentials is based on the Australian Commission on Safety and Quality in Health Care’s National Consensus Statement: Essential elements for safe and high-quality end-of-life care, and the Commission provides ongoing advice to the project.  Close collaborations on a range of strategic and research matters are sustained with the Research Centre for Palliative Care, Death and Dying, and CareSearch, both at Flinders University.

More than 15,000 doctors, nurses and allied health professionals are engaged with End-of-Life Essentials, a free, peer-reviewed and evidence-based online education on end-of-life care in hospitals.

For healthcare professionals knowing when and how to introduce and discuss end-of-life issues and concerns requires confidence.  Responding to patient questions like What will happen to me? or How long do I have left? or How do I tell my son? require confidence and skills. Also vital is being confident in knowing how to relieve a variety of multifactorial symptoms. These skills, confidence and capacity to deliver end-of-life care are increasingly needed by doctors, nurses and allied health professionals who work in hospitals. End-of-Life Essentials modules cover a range of clinically relevant and evidence-based learning materials with quizzes, evidence links and educational videos. Clinicians are encouraged to critically examine their own practice and build on their individual expertise across a wide range of issues which are fundamental to quality and safe end-of-life care in hospitals.

Topics in the education include:

  • Dying, a normal part of life.
  • Patient centred communication and shared decision-making.
  • Recognising the end of life.
  • End-of-life care in Emergency Departments.
  • Paediatric end-of-life care.
  • End-of-life care in chronic complex illness.
  • Imminent death – how to respond.
  • Planning end-of-life care – goals of care.
  • Teams and continuity for the patient.
  • Responding to concerns and when to refer to specialist services.

End-of-Life Essentials has also created new resources to assist healthcare professionals during the COVID-19 pandemic, including a new educational video outlining critical conversations. This video aims to empower health professionals to have goals of care discussions with patients or families during the COVID-19 pandemic. These resources can be accessed at our website.

End-of-Life Essentials is funded by the Australian Government, Department of Health.

References

  1. Australian Institute of Health and Welfare Deaths in Australia: Leading underlying causes of death by sex, 2017, accessed 01/01/2020 https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/leading-causes-of-death
  2. Australian Institute of Health and Welfare, Deaths in Australia: Deaths by sex and age group, 2017 accessed 01/01/2020 https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/age-at-death
  3. Palliative Care Australia, (2018).Palliative Care Service Development Guidelines, accessed 7/02/2020 https://palliativecare.org.au/wp-content/uploads/dlm_uploads/2018/02/PalliativeCare-Service-Delivery-2018_web-1.pdf
  4. Australian Commission on Safety and Quality in Health Care. (2015) National Consensus Statement: essential elements for safe and high-quality end-of-life care. Sydney: ACSQHC.

More about the author…

Kim Devery has worked as a nurse in Africa, USA, UK and Australia across a wide variety of clinical practice settings including palliative care. She is currently Associate Professor in Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Australia, where she leads the strategic development of the palliative care postgraduate courses. She is also project lead of End-of-Life Essentials.

Links

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2 Responses to End-of-Life Essentials: Increasing professionals’ skills and confidence in end-of-life care

  1. Martha Rabwoni says:

    That is really a good idea of empowering the health professional with end of life care skills .
    I agree with you.

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