PhD Studentship: The Development of an Intervention to Reduce Inappropriate Admissions from Care Homes to Acute Hospitals for End-Of-Life Care

Bournemouth University - Faculty of Health & Social Sciences

Lead Supervisor name: Sam Porter

Background and Rationale

Ensuring dignity and care quality at the end of life were key priorities of the End of Life Care Strategy (DH 2008); much has improved in the interim although some inadequacies persist, particularly for those whose end of life needs are complex and harder to define (NHS England 2014), making management problematic for care staff. The phenomenon of transfer of aged care home residents to acute hospitals in the last days and hours of their lives in circumstances where their imminent death is expected has been identified as a significant failing in the organisation of end-of-life care (Public Health England 2013).

The most important negative consequence involves the experience of patients and their loved ones. To end one’s life in an ambulance, accident and emergency department, or acute ward is unlikely to be conducive to a good death in comparison to being cared for in familiar surroundings.

In addition to negative client experience is the burden that such admissions place upon emergency and acute healthcare services. Despite policy initiatives to encourage end-of-life care as part of the remit of care homes (NHS 2006), there is evidence that in many cases current practice leads to inappropriate emergency admissions at the end of life.

Aim

To develop a supportive intervention to enable care homes to provide excellent palliative and end-of-life care in situ.

Objectives

  1. To identify the barriers to and opportunities for the provision of appropriate palliative and end-of-life care in care homes.
  2. To identify mechanisms that can counter identified barriers and provide care home staff with the knowledge, skills, resources and support to effectively perform palliative and end-of-life care.
  3. To develop an intervention that incorporates these mechanisms in a manner that takes account of the social, organisational and economic context within which care homes operate.

Methodology

This research will adopt a critical realist evaluation approach.

Methods

  1. A systematic literature review of end-of-life care in care homes.
  2. A realist review to uncover theories that explain current practices.
  3. Semi-structured individual and focus group interviews to identify stakeholders’ experiences and interpretations of the current context and practice of end-of-life care in care homes.
  4. Analysis of stages 1-3 to identify programme theories about the mechanisms required to support effective end-of-life care.
  5. Incorporation of programme theories into an intervention designed to reduce inappropriate admissions at the end of life.
  6. Realist interviews with stakeholders to refine the programme theories and to enhance the feasibility of the intervention.

What does the funded studentship include?

Funded candidates will receive a maintenance grant of £14,000 per annum (unless otherwise specified), to cover their living expenses and have their fees waived for 36 months. In addition, research costs, including field work and conference attendance, will be met.

Funded Studentships are open to both UK/EU and International students unless otherwise specified.

Closing date: The first call for applications will close on 15 December 2016.

For further information on how to apply click the ‘Apply’ button below or email pgradmissions@bournemouth.ac.uk.

Share this PhD
     
  Share by Email   Print this job   More sharing options
We value your feedback on the quality of our adverts. If you have a comment to make about the overall quality of this advert, or its categorisation then please send us your feedback
Advert information

Type / Role:

PhD

Location(s):

South West England