An evidence based proposal to change practice in the assessment and documentation of the spiritual needs of palliative care patients

Bradley, Carol (2017) An evidence based proposal to change practice in the assessment and documentation of the spiritual needs of palliative care patients. Masters thesis, University of Cumbria. Item availability may be restricted.

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Abstract

Assessing the spiritual needs of patients is fundamental to providing holistic care, particularly within a palliative setting (Department of Health, 2008). This proposal is set within a hospice which provides care through inpatient, hospice-­at-­home and day services. ‘Spirituality’ is identified in the admission, multidisciplinary team meeting and care of the dying templates of the electronic records, but these are rarely completed and usually limited to patient's affiliation to a particular religion. Whilst some spiritual care occurs informally, it is evident from the inadequacy of documentation that staff lack understanding and confidence in this aspect of care. Lewin’s (1947) “unfreeze-­change-­refreeze” model will be used to plan, implement and evaluate the proposed change in practice, which aims to introduce a more effective spirituality assessment process and improve the documentation of patients’ spiritual needs. The literature shows that the definition of spirituality is changing from the purely ‘religious’ to a broader understanding about people’s core values and beliefs. This is reflected in the National Institute of Health and Care Excellence guidelines, which recommend that healthcare workers assess patient’s spiritual needs, in order to inform care planning and referral for specialist support. A multidisciplinary approach to providing spiritual care is suggested, based on the Marie Curie Cancer Care (2003) Spiritual and Religious Care Competencies for Specialist Palliative Care. Identifying spiritual needs is an essential part of the role of healthcare staff, especially at the end of life. Lack of education leaves staff feeling ill-­equipped and lacking confidence in talking to patients about their spiritual needs. Providing experience-­based education and the use of an assessment tool have been shown to improve assessment and documentation. A small multidisciplinary team will use the collaborative approach of co-operative inquiry (Heron, 1996) to: reflect on and ‘unfreeze’ the current situation; develop experiential workshops and introduce a spirituality assessment tool to instigate a ‘change’ in practice; use staff reflections, in an ongoing cycle of reflection and action, to inform improvements in the education and the assessment tool; and develop a spirituality policy that provides standards for staff education and patient care to establish the ‘refreeze’ -­ embedding the change into the everyday care of patients within the hospice services. Formative evaluations and reflections of the stakeholders will inform the ongoing development of the change process. Summative evaluations will show whether the education and implementation of a spiritual assessment tool has effectively improved the assessment and documentation of spiritual care needs.

Item Type: Thesis (Masters)
Departments: Faculty of Health and Science > Nursing, Health and Professional Practice
Additional Information: Dissertation submitted in part fulfilment for the MSc in Advanced Practice (Clinical).
Depositing User: Anna Lupton
Date Deposited: 11 Oct 2017 11:34
Last Modified: 11 Oct 2017 19:07
URI: http://insight.cumbria.ac.uk/id/eprint/3279

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