Project Echo

Connecting Palliative Care Across Ireland

Project ECHO AIIHPC: Nursing Homes

The first project ECHO AIIHPC training programme, funded by the HSE, was delivered to nursing homes within South Dublin and facilitated by the multidisciplinary palliative care team at Our Lady's Hospice & Care Services. The next phase, which commenced in February 2018, extended invitations out to the remaining homes within Dublin and is facilitated jointly by the multidisciplinary palliative care teams at St Francis Hospice and Our Lady's Hospice & Care Services.

The ECHO AIIHPC Nursing Home project is designed to support nursing home staff to improve their knowledge and skills in the care and management of patients with a wide range of palliative healthcare needs. Phases one and two of the project brought together palliative care staff from St Francis Hospice and Our Lady’s Hospice & Care Services (the hub) and nursing home staff (the spokes). Phase threecommenced in May 2019 in collaboration with Milford Care Centre, linking in with 15 nursing homes in the mid west of Ireland.

Each ECHO will usually last one hour and thirty minutes, accessed from within each nursing home facility using teleconferencing software.  Through fortnightly teaching sessions and case presentations, nursing home staff will have the opportunity to discuss patient scenarios which they have found challenging and determine the best course of future treatment. The network will foster a spirit of learning from each other in a safe environment.

The key aim of the Nursing Homes project is to build skills and knowledge of staff to improve their resident’s experiences and avoid unnecessary emergency department attendances or hospital stays.  A further objective is that nursing home staff teams will feel empowered to access relevant palliative care services appropriately and become an effective connected learning community.

Phase One Aims & Objectives were to:

  • Determine whether confidence levels were enhanced among the participating nursing homes  in managing the conditions specifically relating to the topic discussed
  • Determine whether enhanced confidence levels, if present, persisted for at least 6 weeks.

Results

  • 22 participating nursing homes participated
  • Staff confidence was enhanced by 40% post echo
  • Effect persisted for at least 6 weeks post echo
  • Effect was similar regardless of years experience, staff role

A full report on the evaluation of the first phase of Project ECHO AIIHPC: Nursing Homes can be viewed here

Phase Two Aims & Objectives were to

  • Determine if transfers to hospital reduced by the programme?
    • Weekend transfers
    • Contact out-of-hours doctor
    • Duration of hospital stay
  • Determine if the programme improve likelihood of advance care planning among those transferred

Data collection and analysis on phase two is ongoing

Further information can be viewed here

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