Community implementation of home care palliative care education.
OBJECTIVE
The purpose of this National Cancer Institute-funded training project was to improve end-of-life care agencies through implementation of a palliative care curriculum. The Home Care Outreach for Palliative Care Education (HOPE) program was designed to improve the knowledge and skills of home healthcare professionals who provide care to the terminally ill and their families at home.


METHODS
A five-module palliative care education curriculum was designed and implemented in five home care agencies in the Los Angeles area. One hundred twenty-five nurses and 28 home health aides participated. The methods of data collection included two written surveys conducted before and after intervention, chart audit tool and a case study analysis form.


RESULTS
The precourse data revealed deficiencies in home-care agency staff knowledge in and clinical aspects of end-of-life care. Regarding agency nurses' knowledge on end-of-life issues, the overall percentage scores from preeducation to posteducation rose from 84.6% to 89.0% (P =.0001). Participants rated the education program as extremely valuable for the home care agency staff.


CONCLUSIONS
As home care will likely continue to be a primary setting for end-of-life healthcare, improvement of palliative care education in home health agencies is needed. The HOPE project provided insight and experience in the education of nonhospice home care staff in end-of-life care. Participant responses and evaluations indicated that end-of-life care education can improve the quality of care provided by home health agencies. Finally, this education program may result in a heightened awareness of hospice care and, although not objectively quantified, perhaps an increase in referrals to hospice.
Ferrell
Betty R
BR
City of Hope National Medical Center, Dept. of Nursing Research & Education, Duarte, California 91010, USA.
Borneman
Tami
T
D006302:Health Services Research; D006699:Home Care Services; D006801:Humans; D009369:Neoplasms; D010166:Palliative Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D019452:Terminally Ill