title: Staff perceptions of palliative care in a public Australian, metropolitan emergency department.
abstract: OBJECTIVE
  The primary aim was to investigate staff experiences and attitudes towards palliative care provision in a public metropolitan ED.
  
  
  METHODS
  Using a previously validated survey tool, data were collected from ED clinical staff using Likert-type, open-ended and dichotomous items asking about perceptions of palliative care and education needs. Comparisons were made between nursing and medical staff.
  
  
  RESULTS
  Medical staff and nurses' perceptions of palliative care were similar, differing on only 10 of 37 (Likert) items. All staff reported confidence with symptom management, whereas medical staff felt more confident with decision-oriented communication and nurses were more supportive of nasogastric feeding. Staff were moderately accurate in determining the five most common causes of death. Four out of five conditions selected as appropriate for palliative care were cancer diagnoses. End-of-life communication and ethical issues were the two most frequently requested areas for further education.
  
  
  CONCLUSIONS
  Our study suggests that overall ED staff were confident regarding symptom management in palliative care. Cancer diagnoses were overrepresented in both the top five causes of death and conditions most appropriate for a palliative approach, suggesting that staff might underestimate the role of a palliative approach in non-cancer diagnoses. Areas suggested for further education include communication and ethical issues surrounding end-of-life care.
authors.affiliation: School of Primary, Aboriginal and Rural Health Care, Emergency Medicine (Academic Unit), University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Russ
authors.affiliation: School of Primary, Aboriginal and Rural Health Care, Emergency Medicine (Academic Unit), University of Western Australia, Perth, Western Australia, Australia.|Emergency Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Mountain
authors.affiliation: Emergency Department, St John of God Murdoch Hospital, Perth, Western Australia, Australia.|School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Rogers
authors.affiliation: Emergency Department, St John of God Murdoch Hospital, Perth, Western Australia, Australia.
authors.forename: Freya
authors.initials: F
authors.lastname: Shearer
authors.affiliation: Centre for Nursing and Midwifery Research, St John of God Murdoch Hospital, Perth, Western Australia, Australia.|School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.|School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
authors.forename: Leanne
authors.initials: L
authors.lastname: Monterosso
authors.affiliation: Centre for Nursing and Midwifery Research, St John of God Murdoch Hospital, Perth, Western Australia, Australia.|School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Gail
authors.initials: G
authors.lastname: Ross-Adjie
authors.affiliation: School of Nursing and Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Rogers
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003142:Communication; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D013727:Terminal Care / Q000592:standards; D055815:Young Adult
keywords: emergency department; emergency medicine; palliative care