Katrine Staats,Oscar Tranvag and Ellen Karine Grov
University of Bergen, Norway
Posters & Accepted Abstracts: RRJMHS
International studies show a majority of patients receiving palliative care wish to remain at home until they die. Patients and their relatives affirm efficient symptom alleviation is an important factor for living at home until death. A central tool for ensuring quality symptom management for home-dwelling, terminally ill patients is the medication kit recommended by the international consensus group, National Institute for Health and Care Excellence. The intent of the medication kit is simple and effective symptom management for home-dwelling patients in the terminal phase to be facilitated by home care services. Home care nurses assist many advanced cancer patients desiring to live in the familiar surroundings of their own home until the day they die. The purpose of this study is to increase the understanding concerning home care nurse experience with the Norwegian version of the medication kit as a tool in symptom management for the terminally ill. The study had a qualitative, descriptive, and explorative design, based on hermeneutic methodology. Two focus group interviews plus four subsequent in-depth interviews helped generate data. The nurses reported how thorough planning and clear instructions on medication kit usage strengthened nurse confidence and competence, facilitating proper application. Good collaboration with primary physicians, including accessibility and clarifying meetings in particular, was necessary. In the past, infrequent use of the medication kit hindered its relevance for symptom management. Home care nurses were often alone with the responsibility for assessing the patient and administering medications, leading to unjustifiable professional conditions, particularly during night shifts. Thus, clear guidelines, planning and clarifying meetings with primary physicians, as well as increasing competence in symptom alleviation in the terminal phase, helped facilitate the use of the medication kit. A system that ensures available professional resources around the clock was also found essential. Recruiting competent nurses to home care services and establishing palliative teams in the municipal health services, available 24 hours, will enhance professionally tenable practice and help fulfill the desire of many patients who wish to die in their own homes.
Katrine Staats has obtained her MSc, and is an Oncology Nurse. She is pursuing her PhD, Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Norway.
E-mail: [email protected]