UPDATED - Implementation of the caring@home resources in the ACT
In the nation's capital, the caring@home resources are being rolled out into services across the State.
Rachel Bilton-Simek, Palliative Education Coordinator from Clare Holland House in Canberra has been tasked with implementing the caring@home resources and reports on the roll-out. ************************
On Wednesday 30 July 2019, Rachel presented a poster at the Canberra Health Annual Research Meeting (CHARM) See photo below. As a quality improvement activity, the ACT Home-Based Palliative Care Team is trialling the use of these caring@home resources. Part of this trial includes identifying economical ways of replicating the initial free resources for future sustainability.
All key stakeholders were invited to attend an information session about the caring@home resources.
• All nurses completed the one-hour caring@home online education.
• After a one month trial, a survey was sent to nurses to collect qualitative data about the use of caring@home resources.
• Carers could complete a survey in the caring@home package for carers and return it anonymously to University of Technology Sydney (UTS), the evaluator for the caring@home project. Ethics approval was obtained from the UTS Human Research Ethics Committee.
The caring@home resources were well-received by carers and nurses in the ACT Home-Based Palliative Care Team. They are excellent resources to support the provision of patient-centred care for people who would prefer to be cared for and, if possible, to die at home.
The way forward includes working with staff in the ACT Health TCH palliative care team to identify the role for caring@home resources for patients not yet receiving care from the ACT Home-Based Palliative Care Team.
ACT palliative care services have been assisting caregivers to help manage breakthrough symptoms in home-based patients for a long time – the consistency, transparency and usefulness of the resources in the caring@home package was obvious to the team.
The CNC of the home-based specialist palliative care team at Clare Holland House and I felt that the caring@home resources nicely filled a gap we had already identified. Prior to becoming aware of the caring@home project we were on the brink of developing something locally.
I had the opportunity to be a part of the caring@home Education Advisory Group, meaning I could be involved in the development of the resources and ensure that the concerns for our local nurses were discussed and addressed.
As ACT palliative care services are divided into teams, the caring@home implementation will begin in the home-based team to give the opportunity to iron out any unseen local ‘glitches.’
Following this, the implementation will roll out to the hospital palliative care team at The Canberra Hospital and The Calvary Public Hospital.
The ongoing flow from this will then reach the LINK team and ultimately the community nurses.
Our specialist palliative care nurses are slowly but surely completing the online education modules available on the caring@home website.
Our Clinical Nurse Consultant and I have been working through the logistics of closely replicating the caring@home resources and storing the tools from the kit for use by our palliative care team.
We've been speaking with printers about producing the syringe labels and carer handbook, and storming shops for containers to use as we produce our practice demonstration kits. We think the medicines diary is a great resource and hope to have this professionally printed too - the versions in the caring@home kits look so impressive.
So far, we have had meetings across the Territory, to ensure that our overnight support nurses are on board, as well as getting our discharge planners and other factions of ACT Health familiar with the project.
One of the first hurdles was reworking our community medications policy in such a way that both the community nurses and specialist palliative care nurses felt guided and supported appropriately. The caring@home resources were especially useful in guiding this process.
Our nurses are excited to begin using the caring@home resources in the community. Even though this change has necessitated some extra work within our services to implement it properly, we are really looking forward to having these resources in use in the community.
Much of what the caring@home project brings is simply streamlining what we already do, which I am sure is similar for other services around Australia. It is wonderful that there are now best-practice and standardised resources that any service in Australia can use. Our nurses will be able to have documentation that the education they have given willing carers is consistent and thorough, and the coloured syringe labels will be clearer and safer.
The team at caring@home have been fabulous in answering all our weird questions and incorporating our suggestions too.
While the implementation is slow, we believe taking our time with a thorough and complete implementation process will set up the project for ongoing success and bring dividends for our patients and carers in the coming months.