title: Using syringe drivers in palliative care within a rural, community setting: capturing the whole experience.
abstract: The aim of this research was to understand how the introduction of a syringe driver, which is considered routine practice in many palliative care settings, impacted on patients, carers and community nurses within a rural, community setting. A phenomenological study was conducted exploring the experiences from the perspective of patients (n=4), carers (n=9) and community nurses (n=12) when syringe drivers are used at home. We interviewed patients and carers in their own homes and conducted two focus groups with community nurses who had an interest in palliative care but were not specialists. Despite the wide use of syringe drivers within palliative care, our study found their use among community nurses, particularly in rural areas can be variable with frequent time lapses between a nurse's exposure, impacting on both their technical abilities and knowledge. In-depth interviews with patients revealed few barriers to their use, but carers clearly identified areas where their expectations and experiences differed and where more information setting realistic goals of care would have been helpful. The authors conclude that although nurses require competencies related to syringe drivers, they also need an in-depth knowledge of the actions of the drugs and the likely changes which occur physiologically as patients approach the end of their life. This will ensure accurate information is delivered, and facilitate meaningful dialogue.
authors.affiliation: School of Nursing Midewifery and Social Care, Faculty of Health Life and Social Sciences, EdinBurgh Napier University, Edinburgh, UK. s.cruickshank@napier.ac.uk
authors.forename: Susanne
authors.initials: S
authors.lastname: Cruickshank
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Adamson
authors.forename: Janice
authors.initials: J
authors.lastname: Logan
authors.forename: Katie
authors.initials: K
authors.lastname: Brackenridge
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D003152:Community Health Nursing / Q000193:education / Q000458:organization & administration*; D003299:Cooperative Behavior; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D018718:Home Infusion Therapy / Q000295:instrumentation / Q000451:nursing / Q000523:psychology; D006801:Humans; D007260:Infusion Pumps; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology; D018579:Patient Selection; D036301:Qualitative Research; D019035:Rural Health Services; D012606:Scotland; D011795:Surveys and Questionnaires