Implementing and sustaining evidence-based practices in long-term care.

Community of Practice for Pain and Palliative Care: A Success Story

By: Laurie Wheeler RN

Chelsey Park LTC Home, London

It was the winter of 2013, when a group of long-term care (LTC) health care providers attended the “CORE Learning Essential Approaches to Palliative Care” in London, Ontario. The group realized they shared common concerns in managing resident’s pain and in providing palliative and end-of-life care.  The idea of a LTC Community of Practice (CoP) for pain and palliative care was born.

The group wanted a forum for LTC homes to discuss evidence-based practices; learn from each other; and exchange ideas on meeting the Long-Term Care Homes Act, 2007 legislative requirements. They set goals to identify the learning needs of the LTC staff and to review key best practice guidelines from the Registered Nurses’ Association of Ontario (RNA0); the Assessment and Management of Pain and the End-of-Life Care during the Last Days and Hours, 2011.The vision of the CoP was to become a network with as many LTC homes and community partners as possible.

Laurie Wheeler, Quality Nurse Coordinator at Chelsey Park LTC home and Janette Byrne, Nurse Educator and Palliative Pain and Symptom Management Consultant with St. Joseph’s Health Care took the lead.  At the start, seven LTC homes signed on. Now, the CoP has increased to 18 LTC homes and meets once a quarter. Community partners include a pharmacist, a Western University Faculty of Health Sciences professor, a chaplain, a volunteer/marketing coordinator, a social worker and the region’s RNAOs LTC Best Practice Coordinator.

In 2014, CoP members completed the Quality Palliative Care in LTC Competency Assessment Checklist.  The results of the survey revealed there were gaps in many homes on how they provided spiritual care at end of life.  This resulted in the Spiritual Care sub-committee developing an “End of Life Spiritual Care Toolkit for LTC staff.” The plans are to share this resource with other LTC homes in the Southwest Local Health Integration Network (SWLHIN).

Response to the CoP is positive.  It enjoys the support from the LTC home administrative teams and the palliative pain and symptom management consultation program.  “The SWLHIN is pleased with what the CoP has achieved,” Byrne states.  “I want to tell you, this group is making headlines in the nursing home world.  I heard from a colleague, she had a request from a home in her region to start such a group with them.  How does it feel to be on the cutting edge?” remarks Byrne.

The Pain and Palliative CoP celebrates over six years of success.  Further proof to the success of the CoP is when Laurie Wheeler RN, received the Nursing Leadership award in 2018 from the Ontario Long Term Care Association.  The CoP will present a poster on their work at the Hospice Palliative Care Ontario annual conference in 2019.

-About Chelsey Park LTC Home-
Chelsey Park is a 247-bed for-profit long-term care home located in London, South West Ontario.

PDF: Community of Practice for Pain and Palliative Care: A Success Story