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    Evaluating the systematic implementation of the 'Let Me Decide' advance care planning programme in long term care through focus groups: staff perspectives.

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    Authors
    Cornally, Nicola
    McGlade, Ciara
    Weathers, Elizabeth
    Daly, Edel
    Fitzgerald, Carol
    O'Caoimh, Rónán
    Coffey, Alice
    Molloy, D William
    Issue Date
    2015-11
    Keywords
    RESIDENTIAL CARE
    END OF LIFE CARE
    ADVANCE DIRECTIVES
    
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    Citation
    Evaluating the systematic implementation of the 'Let Me Decide' advance care planning programme in long term care through focus groups: staff perspectives. 2015, 14:55 BMC Palliat Care
    Publisher
    BMC Palliative Care
    Journal
    BMC palliative care
    URI
    http://hdl.handle.net/10147/605757
    DOI
    10.1186/s12904-015-0051-x
    PubMed ID
    26531317
    Abstract
    The 'Let Me Decide' Advance Care Planning (LMD-ACP) programme offers a structured approach to End-of-Life (EoL) care planning in long-term care for residents with and without capacity to complete an advance care directive/plan. The programme was implemented in three homes in the South of Ireland, with a view to improving quality of care at end of life. This paper will present an evaluation of the systematic implementation of the LMD-ACP programme in the homes.
    Focus groups were conducted with 15 Clinical Nurse Managers and two Directors of Nursing where the programme had been implemented. A semi-structured topic guide was used to direct questions that addressed implementation process, challenges implementing advance care planning, advantages/disadvantages and recommendations for the future. Data was analysed using manifest content analysis.
    Five key categories emerged, with 16 corresponding subcategories. These subcategories emerged as a result of 37 codes. Key benefits of the programme included enhancing communication, changing the care culture, promoting preference-based care and avoiding crisis decision making. Establishing capacity among residents and indecision were among the main challenges reported by staff.
    A number of recommendations were proposed by participants and included multi-disciplinary team involvement, and a blended approach to education on the topic. According to participants relationships with residents deepened, there was a more open and honest environment with family, end of life care focused more on symptom management, comfort and addressing spiritual care needs as opposed to crisis decision making and family conflict.
    The introduction of the LMD-ACP programme enhanced the delivery of care in the long-term care sites and led to a more open and positive care environment.
    Item Type
    Article
    Language
    en
    ISSN
    1472-684X
    ae974a485f413a2113503eed53cd6c53
    10.1186/s12904-015-0051-x
    Scopus Count
    Collections
    St. Finbarr's Hospital

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