University College Cork, College Road, Cork, T12 K8AF, Ireland.
University of Limerick, Limerick, V94 X5K6, Ireland.
Nurse Educ Pract. 2021 Mar;52:103006. doi: 10.1016/j.nepr.2021.103006. Epub 2021 Feb 27.
Many people with dementia reside in long-term care, where limited staff knowledge of dementia palliative care has been identified, along with poor awareness that a palliative approach can assist in identifying unmet care needs. Evidence-based guidance in palliative care for people with dementia is available however, implementing this guidance requires staff engagement and a tailored educational approach. This pre-implementation situational analysis informed a tailored staff education intervention to support the implementation of national guidance on dementia palliative care in long term care. Using a cross-sectional study design, underpinned by the Consolidated Framework for Implementation Research, survey data were collected on site profile, staff demographics, learning needs, and readiness-to change at three residential care sites for older people in Ireland. In total, 69 staff (predominantly nurses and healthcare attendants) completed the surveys. Medication management and management of pain were the most frequently identified learning needs. Staff were confident in their ability to implement change but de-motivation and powerlessness were substantial factors as only one-third of staff were "ready for change". Staffing levels, managing risk during change and perceived reluctance in others were common barriers. These results informed an educational intervention to address the specific care context, staff learning needs and barriers to change prior to implementation.
许多痴呆症患者居住在长期护理机构中，这些机构的工作人员对姑息治疗的认识有限，并且没有意识到姑息治疗方法可以帮助确定未满足的护理需求。然而，针对痴呆症患者的姑息治疗有循证指导，但实施这一指导需要工作人员的参与和量身定制的教育方法。这项实施前的情况分析为支持在长期护理中实施国家痴呆症姑息治疗指南的工作人员教育干预措施提供了信息。该研究采用横断面研究设计，以实施研究综合框架为基础，在爱尔兰的三个老年人居住护理机构现场收集了有关机构概况、员工人口统计学、学习需求和变革准备情况的调查数据。共有 69 名员工（主要是护士和医疗保健人员）完成了调查。药物管理和疼痛管理是最常被确定的学习需求。工作人员对自己实施变革的能力充满信心，但动机不足和无能为力是一个重要因素，只有三分之一的员工“准备好变革”。人员配备水平、变革过程中的风险管理以及其他人的不情愿是常见的障碍。这些结果为在实施前针对特定护理环境、工作人员的学习需求和变革障碍提供了教育干预措施。
