Development of a practice tool for the improvement of palliative sedation practices in nursing homes
Despite advances in palliative care, some dying patients still experience symptoms uncontrollable and unresponsive to conventional symptom treatment. For them, palliative sedation (i.e. administering sedative drugs to lower consciousness) can be a last resort strategy to relieve terminal suffering. Although fairly frequently used it has raised much debate, particularly given recurring reports of improper application, suboptimal performance and poor communication. Research suggests that challenges with palliative sedation are particularly pervasive in nursing homes as these are less equipped or attended by highly specialized staff and where residents' conditions are more complex and unpredictable. Current sedation practice for residents in nursing homes is therefore highly amenable to improvement.
- DEVELOPMENT: to develop the practice tool based on
(a) existing guidelines developed for palliative sedation;
(b) insights into the barriers and facilitators for adequate decision-making and performance of palliative sedation, and for the use of practice tools in nursing homes.
- VALIDATION: to establish feasibility and acceptability of the developed practice tool with physicians.
- PROOF-OF-CONCEPT STUDY: to study the practice tool’s preliminary effectiveness in terms of improving
(a) adherence to due care requirements;
(b) relevant patient and family outcomes.
Research Foundation Flanders (FWO)