Caring Safely at Home Project - Queensland

Summary of Key Points

Palliative care services strive to support patients to live and to die within their setting of choice, usually home, with optimal symptom control and with a pattern of care that is also supportive of lay caregivers. The likelihood of patients remaining symptomatically well managed at home usually depends upon input from lay caregivers who may be required to administer subcutaneous medications. Bereaved carers report their ability to provide subcutaneous injections adds value to patient care; nonetheless many report the need for education and resources to assist them to confidently manage this aspect of their caregiving role. [1]

The purpose of this Australian Government Department of Health and Ageing (DoHA) funded Caring Safely at Home (CSAH) project was to enhance the ability of lay caregivers to manage subcutaneous medications thereby assisting palliative patients access to timely symptom management.

The CSAH project produced a resource and education package, designed to be delivered by clinicians to lay caregivers. The package has been evaluated as improving caregivers’ capacity and confidence to deliver subcutaneous medications - important factors for them when supporting a palliative patient to be cared for at home.

Background

In 2009, the Brisbane South Palliative Care Collaborative (BSPCC) in partnership with the Centre for Palliative Care Research and Education (CPCRE) and Blue Care under the DoHA Supporting Carers of People Requiring Palliative Care at Home initiative developed, piloted and evaluated an education and resource package designed for lay caregivers who are required to administer subcutaneous injections to palliative patients for symptom management in the home setting.

A suite of resources was developed by a team of palliative care clinical, academic and research professionals to support the delivery of consistent information within a standardised educational framework.

Central to the framework is a time effective one-on-one educational session delivered to lay caregivers by registered nurses or doctors.

The educational and resource package is compliant with relevant statutory Queensland requirements and safe medicine practices.

Resources for caregivers

 Resources for clinicians

  • CSAH Standardised Educational Framework (244kb pdf)
  • Detailed Instruction Guidelines (701kb pdf) for the CSAH resources and educational framework
  • A competency checklist (952kb pdf) which provides the clinician with a mechanism to ensure the caregiver is competent to safely inject subcutaneous medications to palliative patients in the home
  • Clinician lanyard (57kb pdf) which provides a useful overview of the educational framework and the colour coding scheme utilised for the medications

Conclusion

A palliative patient’s preference to be cared for at home or for a home death is often reliant upon a lay caregiver being able to confidently and appropriately provide symptom relief. Such provision can require subcutaneous medication management. The CSAH project successfully developed, implemented and evaluated a standardised education and resource package designed to improve the capacity and confidence of lay caregivers to manage subcutaneous medications.

Best practice guidelines

Investigator Contacts

Investigators

Prof Liz Reymond MBBS (Hons) FRACGP FAChPM PhD
Ms Sue Healy RN Ba HSc
Ms Fiona Israel RN MCouns
Dr Margaret Charles PhD, MAPS

Brisbane South Palliative Care Collaborative bspcc@health.qld.gov.au