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    Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services

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    Publication date
    2009
    Author
    Ingleton, C.
    Payne, S.
    Sargeant, Anita R.
    Seymour, J.
    Keyword
    After-Hours Care/organization & administration
    Ambulances/organization & administration/supply & distribution
    *Attitude to Death
    Caregivers/psychology
    Charities
    Focus Groups
    Great Britain
    *Home Care Services
    Humans
    Palliative Care/*organization & administration
    Patient Preference
    Patient Transfer/*organization & administration
    Qualitative Research
    Resuscitation Orders/legislation & jurisprudence
    Terminally Ill/psychology
    Time Factors
    Transportation of Patients/legislation & jurisprudence/*organization &
    administration/standards
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    Abstract
    Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdom by the Marie Curie Cancer Care 'Delivering Choice Programme'. This article explores perceptions of service users and key stakeholders of palliative care services about problems encountered in journeys between care settings during end-of-life care. This article draws on data from interviews with stakeholders (n = 44), patients (n = 16), carers (n = 19) and bereaved carers (n = 20); and focus groups (n = 9) with specialist nurses. Data were gathered in three areas of the United Kingdom. Data were analysed using a framework approach. Transport problems between care settings emerged as a key theme. Four particular problems were identified: (1) urgent need for transport due to patients' rapidly changing condition; (2) limited time to organise transfers; (3) the management of specialist equipment and (4) the need to clarify the resuscitation status of patients. Partnership working between Ambulance Services and secondary care is required to develop joint protocols of care to ensure timely and safe transportation between care settings of patients, who are near their end of life. Commissioning of services should be responsive to the complexities of patients' needs and those of their families.
    URI
    http://hdl.handle.net/10454/6872
    Citation
    Ingleton, C., Payne, S., Sargeant, A. and Seymour, J. (2009) Barriers to achieving care at home at the end of life: transferring patients between care settings using patient transport services. Palliat Med, 23 (8), 723-30.
    Link to publisher’s version
    http://dx.doi.org/10.1177/0269216309106893
    Type
    article
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    Health Studies Publications

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      Snakes and ladders: human resources in nursing

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