Improving Practice

Palliative care is delivered across a range of health care settings and requires a range of core nursing skills to provide holistic nursing care. To this end, competencies and standards for practice have been developed in Australia and elsewhere around the world to articulate the essential requirements for nurses providing palliative care.

Standards and indicators serve to inform you of expectations relating to care. Improving practice requires guidance on how to achieve these standards.

 

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There are standards relevant to all nurses and standards specific to those providing palliative care. It is important that you are familiar with these and what they mean for your professional practice.

For all registered nurses the Nursing and Midwifery board of Australia has defined a national set of competency standards. These are the professional standards against which all nurses are assessed for registration and include:

  • codes of conduct
  • standards for practice, and
  • codes of ethics.

The National Palliative Care Standards (the Standards) (371kb pdf) developed by Palliative Care Australia for specialist palliative care services outline nine core standards to support delivery of high quality care:

  • Assessment of needs
  • Developing the care plan
  • Caring for carers
  • Providing care
  • Transitions within and between services
  • Grief support.

The Palliative Care Nurses Australia (PCNA) Competency Standards for Specialist Palliative Care Nursing Practice comprise five domains: [1]

  • Therapeutic Relationships 
  • Complex Supportive Care
  • Collaborative Practice
  • Leadership
  • Improving Practice.

Across each of the inter-related domains of the PCNA standards 12 competency standards are described. These state the level of achievement required as part of professional practice. The last of these deals with improving practice and describes expectations that focus on continuous improvement through critical inquiry, application of best available evidence, and engagement in critical reflection on palliative care effectiveness and engagement with ongoing professional development.

Guidelines provide the ‘how to’ for meeting prescribed standards. Towards practice improvement the RACGP aged care clinical guide (Silver Book) includes guidance on palliative care for older people. Given the close working relationship between nurses and GPs, and the broadened scope of practice for Nurse Practioners, this guidance resource can be useful for nurses looking to improve practice. Similarly, practice improvement support relevant to the nursing scope of practice when caring for older people can be found in the palliAGED website. In 2017 this evidence-based online guidance resource replaced the Guidelines for a Palliative Approach in Residential Aged Care (APRAC) and the Guidelines for a Palliative Approach for Aged Care in the Community Setting (COMPAC).

 

  1. Canning D, Yates P, Rosenberg JP. Competency Standards for specialist palliative care nursing practice (193kb pdf). Brisbane, QLD: Queensland University of Technology; 2005.

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Last updated 07 April 2021