Strategic interventions to support a palliative approach in aged care

Traditional approaches to best practice implementation in aged care in Australia rely heavily on ‘train the trainer’ models whereby existing staff act as champions for practice improvement. This intervention on its own; has often proven to be overly burdensome on the trainers and ineffective in achieving best practice, and in some instances failed. This project involved strategically targeted interventions using a palliative approach facilitation model to sustain evidence based practice improvement in palliative and end-of-life care. Positive results included: increased staff knowledge, understanding and confidence; improved person-centred approaches to care; and an enhanced team based approach to end-of-life care. Increased quality and use of advanced care planning, palliative care case conference and end of life care plans developed in collaboration with residents and families were also positive outcomes. ‘Train the trainer’ education models can be challenged by a lack of resources and leadership. The palliative approach facilitator, as expert nurse supports, educates, mentors, and guides practice and was demonstrated in this study to improve staff confidence and knowledge, as well as increasing best practice, person-centred care planning; all necessary in the palliative approach journey. Strategic approaches to education and support in aged care are powerful, sustainable, and effective best practice implementation models which readily translate to other settings.