Implementation of IPOS in a specialist palliative care inpatient unit from Southern Switzerland
C. Letras1, P. Piracini1, T. Fusi-Schmidhauser1, C. Gamondi1 (1Bellinzona)
There is solid and increasing evidence within different palliative care settings on the effectiveness of the Integrated Palliative care Outcome Scale (IPOS) as a Patient Reported Outcome Measure (PROM). Its multidimensionality fosters a complete and accurate identification of patients' needs, but to our knowledge this measure has never been used in Southern Switzerland.
The aim of this project was to evaluate the feasibility of implementing the IPOS as a PROM at the Palliative and Supportive Care inpatient unit in Southern Switzerland where specialist palliative care is provided.
After attending the King’s College IPOS workshop and reviewing the literature, a focus group with part of the nursing team was conducted to evaluate the modality of IPOS implementation within our clinical context. Training was then provided to the entire nursing staff through peer-education. The pilot implementation phase lasted for six weeks. Nurses administered the appropriate IPOS version within 48 hours of patient admittance, every subsequent five days, and up to 48 hours prior to discharge.
The interprofessional team was informed about the project. Finally, a questionnaire was submitted to the nursing team (ten nurses) to understand their perception of the IPOS appropriateness within the inpatient unit.
During the pilot implementation phase 19 patients were admitted to our inpatient unit and IPOS was administered to 14 patients with a total of 34 completed forms. A total of eight nurses completed the questionnaire. Six of them highlighted that the "Patient" version was useful for enhancing quality of care provision.
Furthermore, IPOS helped to raise patients’ awareness about their care provision while tailoring it according to their needs. The nurses also observed some disadvantages in performing the IPOS, especially the time requirements and the difficulty to complete the “Staff” version when information from relatives was not available.
The implementation of IPOS in a specialized palliative care inpatient unit was feasible and the perceived impact on care provision was promising. The institution opted to permanently introduce the IPOS as a PROM to guide high-quality care delivery.
Further research is needed to assess the feasibility of implementation in other palliative care contexts.