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A Mixed Methods Knowledge Synthesis about Nursing Care Delivery and Practice Supports for a Palliative Approach

This nursing health human resources research project addresses the need for nursing care delivery models and practice supports that will facilitate the integration of a palliative approach in nursing care settings for people with life-limiting chronic conditions, including acute medical settings, residential care, and home health and across urban and rural geographic contexts.

The project involves the use of literature synthesis and integrated knowledge translation strategies to:

  1. Examine current knowledge about models of nursing care delivery and staffing and skills mix models suitable for the integration of a palliative approach, and
  2. Engage key stakeholders and experts on nursing care delivery systems to facilitate the transfer of knowledge and evaluate the appropriateness and feasibility of nursing care delivery models and recommendations for the integration of a palliative approach in various contexts of nursing care for patients with life limiting illness and their families.

The project involves four components:

  • A mixed-methods literature synthesis of empiric and grey literature on models of nursing care delivery, staffing and skill mix.
  • Analyses of survey data and qualitative interviews. This includes secondary analyses of the iPANEL provincial nurse survey data, structured interviews of nurse managers, and in-depth interviews with nursing leaders and key informants.
  • A two-day “think tank” that engages experts on a palliative approach and models of nursing care delivery.
  • The initiation of two pilot demonstration projects to establish a process for evaluating the appropriateness, feasibility and effectiveness of recommendations for the integration of a palliative approach in particular practice settings for people with life-limiting chronic conditions.


Research Objectives and Questions:

We are seeking answers to the following research questions:

  1. What kind of models of nursing care delivery, including staffing models and skill-mix models, are most appropriate, feasible, and effective for the integration of a palliative approach in the care of patients with chronic life-limiting conditions and their families?
  2. What practice support systems (coaching, mentorship, education, clinical tools for needs assessments and decision making) best facilitate the integration of a palliative approach in different contexts of nursing care delivery?
  3. What are the outcomes (administrative and patient-reported outcomes) that should be considered when evaluating the appropriateness, feasibility, and effectiveness of recommendations pertaining to the integration of a palliative approach in different contexts of nursing care delivery, specifically home health, acute medicine and residential care?
  4. How can models of nursing care delivery be adapted, implemented and monitored to best facilitate the integration of a palliative approach in the BC healthcare system and in particular nursing care settings?

Our overarching goal is to provide knowledge users, including nursing care administrators, decision makers and managers, with a framework and specific recommendations and practice support tools to guide the implementation of appropriate, effective and affordable models of nursing care delivery for patients with chronic life-limiting illness requiring a palliative approach.

Publications:

Project Summary: A Mixed Methods Knowledge Synthesis about Nursing Care Delivery and Practice Supports for a Palliative Approach

Principal Investigators:
Richard Sawatzky
Pat Porterfield

Co-investigators:
Kelli Stajduhar
Della Roberts
Carolyn Tayler
Sally Thorne
Sheryl Reimer-Kirkham
Jennifer Baumbusch
Tilly Schalkwyk
Barbara Pesut

Research Staff:
Joyce Lee

Consultants:
Gail Tomblin Murphy
Duncan Dixon

Project Contact:
Joyce Lee

Timeline:  Commenced August, 2012.  Expected end date July, 2014.
Funding:  Michael Smith Foundation for Health Services:  BC Nursing Research Initiative
 
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