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This study aimed to explore the many roles of palliative care (PC) nurses in addressing the needs of patients with life-limiting illnesses in the acute inpatient setting in New Zealand.
Methods
A scoping review was undertaken, informed by the Joanna Briggs Institute guidelines and utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. In December 2024, a comprehensive search using Pubmed, Scopus, and CINAHL was conducted for peer-reviewed articles published in English between the years 2014 and 2024, with full text available, that focused on PC nursing in the acute setting in New Zealand, Australia, Canada, Ireland, or the United Kingdom. These countries were chosen because their health care systems are similar. Citation searches were undertaken. Grey literature from New Zealand hospitals was also searched.
Results
After selection, 25 pieces of literature were eligible for the review. Nine key areas were found where PC nurses and teams play key roles in the ongoing management of patients and their coordination of care within the last months to last days of life in the acute inpatient setting. The areas were care-coordination, communication facilitation, decision-making, goals and expectations, discharge planning, physical symptom management, holistic symptom management, finances, environment, education, and rapid review. The findings suggest that PC nurses in the acute setting are no longer involved in single episodes of symptom management and ward-based end-of-life nursing, but are responsible for multiple facets of care, facilitated across several different services.
Significance of results
Understanding the complex roles involved in PC nursing can impact the health care outcomes of patients with a life-limiting illness. The scoping review can help inform future staffing requirements and the skill mix and knowledge levels required to provide timely and appropriate PC in the acute environment in New Zealand hospitals.
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