Palliative care nursing during the COVID-19 pandemic: reflections from Melbourne, Australia.

BACKGROUND: Nurses played a critical role in providing care for patients throughout the COVID-19 pandemic. AIM: This study aimed to explore perspectives of Australian palliative care nurses regarding the impact of COVID-19 on the provision of care for patients with advanced illness, or at the end of life. METHODS: The authors conducted a survey of palliative care nurses in ward- and consultation-based roles at a metropolitan health service in Victoria, Australia. FINDINGS: A total of 24 out of 39 nurses completed the survey. Responses included strong themes of fear of COVID-19 and sadness about separating dying patients from their families. CONCLUSION: Delivery of palliative care changed at an individual and service level. Importantly, there were strong themes of adapting to change and 'soldiering on' with the core business of palliative care.

P23-9 Construction of a model for palliative care education for visiting nurses involved with patients with intractable cancer

Background: Cancer patients have been living with some inconvenience and anxiety about recurrence for a longer period while continuing cancer treatment after the initial cancer treatment is completed. In the future, the recuperation period for cancer patients will become longer and more complex. Intractable cancers such as recurrent, metastatic, drug-resistant, and rare cancers are defined as those that do not respond to or are resistant to cancer treatment. In addition, More than 50% of patients with cancer answered “home” as their preferred place to die, and there is a growing need for home treatment that emphasizes their own way of life. Therefore, it is important to encourage the improvement of the quality of home health care nursing related to home treatment cancer patients. Methods: This study has been approved by the Ethical Review Committee of institution. Study 1: A questionnaire was developed from a review of national and international literature, and a pilot web-based questionnaire was administered to visiting nurses. Study 2: An educational program is being planned based on the results obtained in Study 1.Study sessions corresponding to those themes were planned and implemented from May to September 2021 via web-based delivery using ICT. Results: The learning needs for refractory cancer palliative care nursing were included 1. COVID-19 at the home care, 2. ACP and 3. Nutrition Care. Based on our understanding of the above learning needs, nurses participated in the ICT for the intractable cancer nursing study session. Conclusion: As for training opportunities for visiting nurses, home care nursing stations do not have sufficient support systems for learning. In recent years, the number of cancer patients who wish to receive treatment at home has been increasing. The study sessions will be continued in order to obtain outcomes that improve visiting nurses‘ ability to practice cancer nursing through interventions for intractable cancer.

American Academy of Nursing Expert Panel consensus statement on nursing's roles in ensuring universal palliative care access.

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.

Future palliative competence needs - a qualitative study of physicians' and registered nurses' views.

BACKGROUND: Globally, the need for palliative care will increase as a result of the ageing of populations and the rising burden of cancer, non-communicable diseases as well as some communicable diseases. Physicians and registered nurses working in palliative care should have a sufficient level of education and competence in managing the changing needs and requirements of palliative care. There is, however, need for evidence-based palliative care training and education of physicians and registered nurses. The purpose of this study was to describe the views of physicians and registered nurses regarding future competence needs within palliative care. METHODS: The study was conducted through use of a cross-sectional qualitative design. A total of 54 physicians and 110 registered nurses completed an open-ended questionnaire about the future competence needs of palliative care. The data were analyzed using inductive content analysis. RESULTS: The results revealed four main competence needs within palliative care for the coming decade: palliative care competence at all levels within healthcare and social welfare services; individualized palliative care competence; person-centered encounters competence; and systematic competence development within palliative care. CONCLUSIONS: The results offer cues for education and professional development, which can be used to support physicians and registered nurses when future palliative care competences are included in educational programs. Seamless cooperation between palliative care services and educational institutions is recommended to ensure that undergraduate and postgraduate education is based on a continuous assessment of competence requirements within the field of palliative care. Therefore, online multi-professional simulations, for example, could be used to enhance future competencies within palliative care; undergraduate medical, nursing and allied healthcare students as well as postgraduate palliative care professionals and experts of experience could work together during simulations.

Global palliative nursing partnerships in the face of COVID-19.

BACKGROUND: Mutually respectful and long-term global partnerships are critical to increasing hospice and palliative care access as a key component of universal health coverage. The importance of sustained, transnational palliative care collaboration has become more urgent since the COVID-19 pandemic. AIM: To provide an overview of characteristics for successful global palliative nursing partnerships. METHOD: The authors highlight the need to adapt approaches to meet the challenges and demands of COVID-19 in both clinical and academic spaces. Exemplars of thriving global partnerships are provided, alongside palliative nursing considerations and strategies to advance and sustain them. CONCLUSION: The role of nursing to drive and enhance palliative care partnerships, especially with equitable input from low- and middle-income country stakeholders, must be leveraged to advance shared goals and reduce serious health-related suffering around the world.

Optimizing the Global Nursing Workforce to Ensure Universal Palliative Care Access and Alleviate Serious Health-Related Suffering Worldwide.

CONTEXT: Palliative care access is fundamental to the highest attainable standard of health and a core component of universal health coverage. Forging universal palliative care access is insurmountable without strategically optimizing the nursing workforce and integrating palliative nursing into health systems at all levels. The COVID-19 pandemic has underscored both the critical need for accessible palliative care to alleviate serious health-related suffering and the key role of nurses to achieve this goal. OBJECTIVES: 1) Summarize palliative nursing contributions to the expansion of palliative care access; 2) identify emerging nursing roles in alignment with global palliative care recommendations and policy agendas; 3) promote nursing leadership development to enhance universal access to palliative care services. METHODS: Empirical and policy literature review; best practice models; recommendations to optimize the palliative nursing workforce. RESULTS: Nurses working across settings provide a considerable untapped resource that can be leveraged to advance palliative care access and palliative care program development. Best practice models demonstrate promising approaches and outcomes related to education and training, policy and advocacy, and academic-practice partnerships. CONCLUSION: An estimated 28 million nurses account for 59% of the international healthcare workforce and deliver up to 90% of primary health services. It has been well-documented that nurses are often the first or only healthcare provider available in many parts of the world. Strategic investments in international and interdisciplinary collaboration, as well as policy changes and the safe expansion of high-quality nursing care, can optimize the efforts of the global nursing workforce to mitigate serious health-related suffering.

Coronavirus disease 2019 (COVID-19): strengthening our resolve to achieve universal palliative care.

In this paper, we strongly advocate for universal palliative care access during the COVID-19 pandemic. The delivery of universal palliative care services has been called for by leading global health organizations and experts. Nurses are critical to realizing this goal. COVID-19 diagnoses and fatalities continue to rise, underscoring the importance of palliative care, particularly in the context of scant resources. To inform the writing of this paper, we undertook a review of the COVID-19 and palliative care literature and drew on our experiences. It is very clear that investment in nurses is needed to ensure appropriate palliative care services now and into the future. Avoiding futile interventions and alleviating suffering is an ethical imperative for nurses regardless of the setting. Multi-level practices and policies to foster the delivery of safe, high-quality palliative care for all are urgently needed.