Care Home Project Team, St Christopher's Hospice, London, UK.
Palliat Med. 2013 Mar;27(3):209-20. doi: 10.1177/0269216311432899. Epub 2012 Jan 4.
The number of older people in the UK is increasing. A significant proportion of end of life care for this population is currently provided and will increasingly be provided within nursing care homes.
To identify the impact of implementing end of life care policy with regard to the use of the Gold Standards Framework in Care Homes programme, the Liverpool Care Pathway (or an Integrated Care Pathway) and educational/training interventions to support the provision of end of life care within nursing care homes within the UK.
Systematic literature review of published literature and reports.
An electronic search was undertaken of five databases-Medline, CINAHL, EMBASE, Web of Science and the Cochrane library and websites of government and palliative care organisations for papers and reports published between 2000 to June 2010. The reference lists of studies that were retrieved for the detailed evaluation were hand-searched for any additional relevant citations.. Only studies that included comparative outcome data were eligible for inclusion.
Eight papers/reports, incorporating information from three studies were identified. Two studies reported on the implementation of the Gold Standards Framework in Care Homes programme and one the implementation of an Integrated Care Pathway for the last days of life. Improvements occurred in resident outcomes and in relation to staff recognising, managing and meeting residents needs for end of life care.
The studies provided limited evidence on improved outcomes following the implementation of these interventions. Further research is needed, both within the UK and internationally, that measures the process and impact of implementing these initiatives.
英国的老年人数量正在增加。目前，这一人群的临终关怀服务相当一部分是在护理院提供的，而且这一比例还会不断增加。
确定在英国的护理院实施临终关怀政策，包括实施“黄金标准框架”、“利物浦关怀路径”（或综合关怀路径）以及教育/培训干预措施，以支持提供临终关怀服务方面的影响。
对已发表的文献和报告进行系统的文献回顾。
对五个数据库（Medline、CINAHL、EMBASE、Web of Science 和 Cochrane 图书馆）和政府及姑息治疗组织的网站进行了电子检索，以获取 2000 年至 2010 年 6 月期间发表的论文和报告。对检索到的详细评估研究的参考文献进行了手工检索，以查找任何其他相关引文。只有包括比较结果数据的研究才有资格被纳入。
确定了 8 篇论文/报告，其中包含了来自 3 项研究的信息。有两项研究报告了“黄金标准框架在护理院计划”的实施情况，一项研究报告了生命最后几天的综合关怀路径的实施情况。居民的结果以及工作人员对居民临终关怀需求的识别、管理和满足方面都有所改善。
这些研究提供了实施这些干预措施后改善结果的有限证据。需要在英国和国际范围内进行进一步的研究，以衡量实施这些举措的过程和影响。
