The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review

Fee, Anne; Muldrew, Deborah; Slater, Paul; Payne, Sheila; McIlfatrick, Sonja; McConnell, Tracey; Finlay, D; Hasson, Felicity

doi:10.1177/0269216320929559

Cited by 14 publications

(14 citation statements)

References 48 publications

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“…The research community should seek to reach consensus on the most important measures to be assessed in trials, to enable meta-analyses pooling findings from multiple trials to be conducted. Future research may investigate the effects of positive feedback depending on healthcare role, comparing those who have consistent access to feedback (such as oncology staff) (59), to those who feel overlooked and undervalued (such as healthcare assistants) (86). Future research may investigate the effects of positive feedback at multiple levels of the organisation, such as individual impacts like resilience, and organisational culture and system-level change, and whether the effect of positive feedback changes depending on individual or team receipt.…”

Section: Discussionmentioning

confidence: 99%

Health service improvement using positive patient feedback: systematic review and change model

Lloyd

Munro²,

Evans

et al. 2022

Preprint

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Background : Patients, families, and communities regularly provide feedback about care and treatment received from healthcare services, most of which is positive. The aim of this review was to examine how positive feedback creates change within healthcare settings. Methods : Included documents were empirical studies where the full text is publicly available in English, and where a change has occurred within healthcare services attributed to positive feedback from service users, their families, or the community. They were identified through database searches (ACM Digital Library, AMED, ASSIA, CINAHL, MEDLINE and PsycINFO), forwards and backwards citation, and expert consultation. Data was synthesised into a change model describing forms, mediators and moderators of change. A protocol was prospectively registered: https://osf.io/5x46c . Results : Sixty-eight papers were included, describing research conducted in 32 countries across six continents, with qualitative (n=51), quantitative (n=10), and mixed (n=7) methods. Only two described interventional studies. The most common form of feedback was ‘appreciation’ (n=28). The most common recipients were nurses (n=29). Positive feedback was most commonly given in hospitals (n=27) and community healthcare (n=19). Positive feedback mostly led to positive outcomes categorised as (a) short-term emotional change for healthcare workers (including feeling motivated and improved psychological wellbeing), (b) work-home interactional change for healthcare workers (such as improved home-life relationships), and (c) work-related change for healthcare workers (such as improved performance and staff retention). Undesirable changes included embarrassment when receiving feedback, tension in the patient-professional relationship, and envy when not receiving positive feedback. Conclusion : Positive feedback can provide the opportunity to create meaningful health service change. Healthcare managers may wish to use positive feedback more regularly, and to identify and address barriers to staff receiving feedback. Further interventional research is required to establish the effectiveness of receiving positive feedback in creating change, and to understand the influence of feedback content.

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Section: Discussionmentioning

confidence: 99%

Health service improvement using positive patient feedback: systematic review and change model

Lloyd

Munro²,

Evans

et al. 2022

Preprint

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“…The first phase involves a scoping review of policy and related literature to examine and map the types of evidence and policy that inform practice in this area as well as identify gaps in knowledge [ 34 ]. There is no existing published synthesis on the HCA role in OOH palliative care that integrates empirical and grey literature to map the body of literature on this complex and heterogeneous topic [ 35 ].…”

Section: Methods and Analysismentioning

confidence: 99%

Protocol for a mixed methods exploratory investigation into the role and contribution of the healthcare assistant in out-of-hours palliative care

Hasson¹,

McIlfatrick²,

Payne

et al. 2021

BMC Nurs

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Background Most people spend their last year of life at home, with many wishing to die there, but patients may need access to care after hours. Out-of-hours palliative care is delivered by multi-disciplinary teams including Health Care Assistants (HCA). However, little is known about the role, contribution and impact Health Care Assistants have on out-of-hours palliative care services. The aim of this study is to examine the Health Care Assistant role, contribution and impact on service delivery and patient care in out-of-hours community palliative care provided by hospice organisations. Methods and analysis A mixed methods exploratory study consisting of four phases. Phase one involves a scoping review to systematically map and identify gaps in policy and literature on the HCA role in out-of-hours palliative care. In phase two, all United Kingdom hospices will be invited to participate in an online census to enable the development of a typology of out-of-hours services and the contribution of the Health Care Assistant. During phase three organisational case studies representing different service types will collect information from Health Care Assistants, patients, caregivers and service managers to gather qualitative and quantitative data about out-of-hours service provision and the Health Care Assistant role. Finally, phase four will synthesize and refine results through online focus groups. Ethics and dissemination Ethical approval has been obtained for phase two through Ulster University Research Governance Filter Committee, Nursing and Health Research. Findings will be disseminated through practitioner and/or research journals, conferences, and social media.

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“…OOH is 18:30 to 08:00 on weekdays, and all hours at weekends in the United Kingdom (Williams et al, 2019). 'Out of hours'-defined as care provided after the normal hours of work (Fee et al, 2020) Atzema and Maclagan's (2017) scoping review of 85 articles examined the transition of care between the ED and primary care.…”

Section: Out Of Hoursmentioning

confidence: 99%

“…Long ED waits can have a negative impact on the older person presenting with an acute illness or injury alongside underlying medical conditions. Increasingly, the lens is focusing on out of hours care (OOH), which is evident in palliative care where a dearth in research evidence also exists (Fee et al, 2020; Hasson et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Supporting older people following out of hours discharge from the Emergency Department: An integrative review of the literature

Dunnion

Ryan

Goode

et al. 2023

Int J Older People Nursing

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Background For many older people the emergency department (ED) is an important but sometimes difficult step in their healthcare journey. They often attend the ED with co and multi morbidities. Discharge home at evenings and weekends when post‐discharge support services are limited can result in a delay or failure to follow through on their discharge plan leading to adverse health outcomes and in some cases, readmission to ED. Objective The aim of this integrative review was to identify and appraise the support available to older people following discharge from the ED out of hours (OOH). Methods For this review, out of hours referred to those times after 17.30 until 08.00 a.m. on Mondays to Fridays, all hours on weekends and public holidays. Whittemore and Knafl's (Journal of Advanced Nursing, 2005;52:546), framework was used to guide all stages of the review process. Articles were retrieved following a rigorous search of published works using various databases, the grey literature and hand search of the reference lists of the studies included. Results In total 31 articles were included in the review. These comprised systematic reviews, randomised control studies, cohort studies and surveys. Main themes identified included processes that enable support, support provision by health and social care professionals and telephone follow‐up. Results identified a significant dearth of out of hours discharge research and a strong recommendation for more concise and thorough research in this important area of care transition. Conclusion Older person discharge home from the ED presents an associated risk as previous research has identified frequent readmission and periods of ill health and dependency. Out of hours discharge can be even more problematic when it may be difficult to arrange support services and ensure continuity of care. Further work in this area is required, taking cognisance of the findings and recommendations identified in this review.

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The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review

Cited by 14 publications

References 48 publications

Health service improvement using positive patient feedback: systematic review and change model

Health service improvement using positive patient feedback: systematic review and change model

Protocol for a mixed methods exploratory investigation into the role and contribution of the healthcare assistant in out-of-hours palliative care

Supporting older people following out of hours discharge from the Emergency Department: An integrative review of the literature

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