Nurse-led units in palliative care: A concept for consideration

One of the recommendations contained within the SA Health: Palliative Care Services Plan 2008-16 relates to the exploration of nurse-led care settings as an additional element in the population-based configuration of inpatient bed types to better match patient need and preference with available resources.

Nurse-led inpatient care is suggested in instances where the primary intervention required is expert specialist nursing care. This innovation represents a potential option for:
    o Uncomplicated end of life care for deteriorating and terminal patients.
    o Periods of step-down care for stable inpatients.
    o Planned periods of respite care.
    o Inpatients who state a preference for a care with minimal medical
       intervention characterised as a more traditional hospice approach
       to care.

This paper sets out the troubled history of nursing units, the context and the rationale for their emergence as option for consideration in palliative care in Australia today, and the issues of contestation or critique that arise in response to their emergence. The steps involved in piloting and evaluating nurse-led units within regionalised service delivery models will also be discussed, as will the current status of the innovation in South Australia.