Three nurses, all experienced in palliative care but new to a research role, were employed by a Comprehensive Local Research Network to form part of the first network of 'research-active hospices' in the UK. This article outlines the challenges and hurdles faced by the research nurses and illustrates how their achievements can be capitalized on to ensure that future research nurses have a greater insight into the research process when undertaking clinical palliative care research studies in a non-NHS setting. The research nurses' experiences have highlighted issues that need addressing, particularly in relation to research governance-ethical and Research and Development approval for National Institute for Health Research portfolio studies being undertaken in what are effectively classed as non-NHS institutions with NHS patients. These issues are hopefully now being taken forward by those responsible for policy-making, ensuring that an ever-growing population of palliative care patients involved with hospice services has the same access to participation in research as other NHS patients.

Strategy could negate these effects by improving overall wellbeing. What are we doing As part of our strategy we have developed a free weekly programme of in house workshops called Wellness for You. Delivered by a senior complementary therapist the focus is on key elements of wellbeing; using different themes; informal interactive group discussions; practical demonstrations; attendees complete anonymised pre/post evaluations using a likert scale. Objectives To develop a self-care resource for staff support; Improve health and energy; Improve satisfaction in the workplace; Reduce compassion fatigue Results Early results from weekly evaluations have shown that the programme so far is proving to be a great success in creating an improved sense of wellbeing by reducing stress and improving morale -thus improving overall health in the long term. Sustainability The workshops offer a rolling programme that can be used across all departments and in other settings. The programme has already shown benefits for staff in the work place even at this early stage. The focus is on supportive tools and strategies for self-care that all staff can benefit from. Developments of the programme may have human resource benefits i.e. reductions in staff turnover and absenteeism, higher morale and a better workplace to attract staff.

Introduction There is evidence that palliative care patients wish to be involved in palliative care research (Terry et al 2006) but recruitment proves problematic (Bennett 2010). Aims and Methods The purpose of this small study was to understand issues about patient recruitment to research studies in hospice settings from clinicians' and researchers' perspectives. Researchers and clinicians were recruited from various palliative care settings (n=12). Participants were interviewed individually or in pairs using guided questions during June/July 2012. Interviews were recorded, transcribed and content analysis performed. Results The sample included research practitioners (n=3), clinicians (n=7) and professionals with dual research and clinical roles (n=2). Rather than asking all eligible patients, staff practice ‘gatekeeping’, only asking those who fit their ‘ideal participant criteria’. These patients were stereotypically deemed nice, co-operative, chatty and young. Those who tended not to be approached were poorly, emotional, angry or older. However, staff recognised that patients wanted to contribute to research and should be invited. They had experience of patients acting autonomously including those who declined or withdrew from studies so there was some evidence that patients could make these decisions for themselves. Conclusions There appears to be an unwritten code to only include those fitting the ideal research participant stereotype. Secondary screening for the ideal participant may create a biased sample and fail to address issues pertinent to all palliative care patients. Such gate keeping also denies patients the potential satisfaction of having contributed to knowledge development.

BackgroundAscites, a palliative symptom, is the build-up of large volumes of fluid in the peritoneal cavity which is drained at around five litres. If an indwelling catheter isn’t possible then living with large volumes of fluid which are intermittently drained, is very uncomfortable. Earlier research showed that an abdominal support garment improved discomfort and provided support to their large distended abdomens (Preston 2004). However, the garment was too warm and also ‘rode up’ making it difficult to wear especially in warmer weather.AimTo assess the acceptability of a support garment for use with people with ascites.MethodsFive prototypes for a support garment using a range of materials to offer abdominal support were developed with the company Jobskin. The ongoing study with eight participants with ascites (alcohol related liver disease and malignancy) will assess wear-ability and support requirements including an assessment of comfort, ease of putting on/off, mobility and acceptability. The garment, shaped like cycling shorts, can be made in a range of sizes and colours.ResultsA garment was developed using five sections offering different types of pressurised support including a main abdominal area which allows for support but can significantly increase to allow for abdominal growth. The support garment supported an increase in abdominal girth from 70 cm to 110 cm in the initial participant yet remained comfortable. Early results have had it described as ‘invaluable’ by one doctor at the end of life of a patient to help her get in and out of bed when drainage was no longer an option.Interpretation and conclusionsA support garment has been created which can allow for increased abdominal girth yet provide abdominal support. Early indications show it is very acceptable, improves discomfort and offers the support required.

In 2013 a survey of non-qualified staff within one 20 bedded hospice was conducted as part of understanding their concerns about meeting the needs of patients with advanced cancer.In response to the survey which showed that staff on the whole underestimated the palliative care needs of this group and expressed concerns around how to communicate with someone with significant cognitive impairment.The hospice has run a number of training events around dementia open to both qualified and non-qualified staff and has become part of the “dementia friends’” initiative. In addition the in-patient unit underwent an extensive refurbishment which aimed at making the environment more suitable for those with cognitive and visual impairment. The survey was repeated in 2015 across the same groups of non-qualified staff to see if there had been any change in their understanding and perceptions.A total of 65 staff and volunteers have attended a “let’s respect” Course run by the local council.A total of 90 staff and volunteers have become dementia friends.Abstract P-70 Table 1 2013 2015 Response Rate20/43 (46.5%)32/50 (64%)Number over estimating life expectancy16/20 (81%)20/32 (63%)Concerns about their ability to meet a patient with dementia needs15/20 (75%)On-going analysisThe interventions undertaken appear to have raised awareness with more staff willing to be involved in the survey and greater understanding of the condition. Further analysis of the results will be presented at the conference.Further work is being done to see what additional support can be given to address the on-going concerns of the non-qualified staff and enable them to attend appropriate training to build their confidence.