Home > Research > Publications & Outputs > Administering anticipatory medications in end-o...

Electronic data

  • Palliat Med-2015-Wilson-60-70

    Rights statement: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).

    Final published version, 370 KB, PDF document

    Available under license: CC BY-NC

Links

Text available via DOI:

View graph of relations

Administering anticipatory medications in end-of-life care: a qualitative study of nursing practice in the community and in nursing homes

Research output: Contribution to journalJournal articlepeer-review

Published

Standard

Administering anticipatory medications in end-of-life care : a qualitative study of nursing practice in the community and in nursing homes. / Wilson, Eleanor; Morbey, Hazel; Brown, Jayne; Payne, Sheila; Seale, Clive; Seymour, Jane.

In: Palliative Medicine, Vol. 29, No. 1, 01.2015, p. 60-70.

Research output: Contribution to journalJournal articlepeer-review

Harvard

APA

Vancouver

Author

Wilson, Eleanor ; Morbey, Hazel ; Brown, Jayne ; Payne, Sheila ; Seale, Clive ; Seymour, Jane. / Administering anticipatory medications in end-of-life care : a qualitative study of nursing practice in the community and in nursing homes. In: Palliative Medicine. 2015 ; Vol. 29, No. 1. pp. 60-70.

Bibtex

@article{0f3e48ccec1146b2b07aa4bbf527a703,
title = "Administering anticipatory medications in end-of-life care: a qualitative study of nursing practice in the community and in nursing homes",
abstract = "Background: In the United Kingdom, an approach to improving end-of-life care has been the introduction of {\textquoteleft}just in case{\textquoteright} or {\textquoteleft}anticipatory{\textquoteright} medications. Nurses are often responsible for deciding when to use anticipatory medications, but little is known about their experiences.Aim: To examine nurses{\textquoteright} decisions, aims and concerns when using anticipatory medications.Design: An ethnographic study in two UK regions, using observations and interviews with nurses working in community and nursing home teams (n = 8).Findings: Observations (n = 83) and interviews (n = 61) with community nurses. Nurses identified four {\textquoteleft}conditions{\textquoteright} that needed to be established before they implemented anticipatory medications: (1) irreversibility; (2) inability to take oral medication; (3) where the patient was able, they should consent and (4) decision had to be independent of demands or requests from patient{\textquoteright}s relatives. By using anticipation medications, nurses sought to enable patients to be {\textquoteleft}comfortable and settled{\textquoteright} by provision of gradual relief of symptoms at the lowest dose possible. They aimed to respond quickly to needs, seeking to avoid hospital admission or medical call-out, while adhering to local prescribing policies. Worries included distinguishing between pain and agitation, balancing risks of under- and over-medication and the possibility of hastening death.Conclusion: Nurses take a leading role in the administration of anticipatory medications. Nurses apply consideration and caution to the administration of anticipatory medications but some experience emotional burden. Education, training and experience played a role in the nurses{\textquoteright} confidence and should continue to be central to efforts to improving the quality of palliative care in the community and nursing homes.",
keywords = "Anticipatory medication , {\textquoteleft}just in case{\textquoteright}, end of life , community nursing, nursing homes, decision-making, symptom management, place of death, qualitative",
author = "Eleanor Wilson and Hazel Morbey and Jayne Brown and Sheila Payne and Clive Seale and Jane Seymour",
note = "This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).",
year = "2015",
month = jan,
doi = "10.1177/0269216314543042",
language = "English",
volume = "29",
pages = "60--70",
journal = "Palliative Medicine",
issn = "0269-2163",
publisher = "SAGE Publications Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Administering anticipatory medications in end-of-life care

T2 - a qualitative study of nursing practice in the community and in nursing homes

AU - Wilson, Eleanor

AU - Morbey, Hazel

AU - Brown, Jayne

AU - Payne, Sheila

AU - Seale, Clive

AU - Seymour, Jane

N1 - This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).

PY - 2015/1

Y1 - 2015/1

N2 - Background: In the United Kingdom, an approach to improving end-of-life care has been the introduction of ‘just in case’ or ‘anticipatory’ medications. Nurses are often responsible for deciding when to use anticipatory medications, but little is known about their experiences.Aim: To examine nurses’ decisions, aims and concerns when using anticipatory medications.Design: An ethnographic study in two UK regions, using observations and interviews with nurses working in community and nursing home teams (n = 8).Findings: Observations (n = 83) and interviews (n = 61) with community nurses. Nurses identified four ‘conditions’ that needed to be established before they implemented anticipatory medications: (1) irreversibility; (2) inability to take oral medication; (3) where the patient was able, they should consent and (4) decision had to be independent of demands or requests from patient’s relatives. By using anticipation medications, nurses sought to enable patients to be ‘comfortable and settled’ by provision of gradual relief of symptoms at the lowest dose possible. They aimed to respond quickly to needs, seeking to avoid hospital admission or medical call-out, while adhering to local prescribing policies. Worries included distinguishing between pain and agitation, balancing risks of under- and over-medication and the possibility of hastening death.Conclusion: Nurses take a leading role in the administration of anticipatory medications. Nurses apply consideration and caution to the administration of anticipatory medications but some experience emotional burden. Education, training and experience played a role in the nurses’ confidence and should continue to be central to efforts to improving the quality of palliative care in the community and nursing homes.

AB - Background: In the United Kingdom, an approach to improving end-of-life care has been the introduction of ‘just in case’ or ‘anticipatory’ medications. Nurses are often responsible for deciding when to use anticipatory medications, but little is known about their experiences.Aim: To examine nurses’ decisions, aims and concerns when using anticipatory medications.Design: An ethnographic study in two UK regions, using observations and interviews with nurses working in community and nursing home teams (n = 8).Findings: Observations (n = 83) and interviews (n = 61) with community nurses. Nurses identified four ‘conditions’ that needed to be established before they implemented anticipatory medications: (1) irreversibility; (2) inability to take oral medication; (3) where the patient was able, they should consent and (4) decision had to be independent of demands or requests from patient’s relatives. By using anticipation medications, nurses sought to enable patients to be ‘comfortable and settled’ by provision of gradual relief of symptoms at the lowest dose possible. They aimed to respond quickly to needs, seeking to avoid hospital admission or medical call-out, while adhering to local prescribing policies. Worries included distinguishing between pain and agitation, balancing risks of under- and over-medication and the possibility of hastening death.Conclusion: Nurses take a leading role in the administration of anticipatory medications. Nurses apply consideration and caution to the administration of anticipatory medications but some experience emotional burden. Education, training and experience played a role in the nurses’ confidence and should continue to be central to efforts to improving the quality of palliative care in the community and nursing homes.

KW - Anticipatory medication

KW - ‘just in case’

KW - end of life

KW - community nursing

KW - nursing homes

KW - decision-making

KW - symptom management

KW - place of death

KW - qualitative

U2 - 10.1177/0269216314543042

DO - 10.1177/0269216314543042

M3 - Journal article

VL - 29

SP - 60

EP - 70

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 1

ER -