CareSearch Blog: Palliative Perspectives

At CareSearch we acknowledge and respect the Kaurna people, the traditional custodians whose ancestral lands on which CareSearch located.

Naa Marni? This greeting in Kaurna language translates to ‘Are you all good?’

I recall once walking through a university corridor on my way to give a tutorial, and overhearing some students complaining that they couldn't understand why they had to spend so much time in their course on Aboriginal Health. I was quite shocked by this, because to me the reason was obvious – Aboriginal and Torres Strait Islander people die at least 10 years earlier than non-indigenous Australians. How had they missed this vital point?

One of the key goals of the Close the Gap campaign for Indigenous health equality is to reduce the gap in life expectancy and healthcare access between Aboriginal and Torres Strait Islander peoples and the non-indigenous Australian population.
 

New healthcare research is being produced at an exponential rate and the challenges for clinicians to keep abreast of it are well documented. Perhaps less frequently discussed is the question of what happens once relevant evidence has been identified. How does it move from the page to have a tangible influence on patient care or health system outcomes?  

Despite the abundance of research evidence available, we know that it is often slow to reach those that need it, and even slower to be implemented. An oft cited time lag is a staggering 17 years! The implication is that patients may be receiving ineffectual treatments, out of step with best practice recommendation, in the meantime. This must inevitably impact on patient safety, quality improvement processes, and healthcare costs across the sector. 
 

There is no doubt that nurses are fundamental to health care. There are over 350,000 nurses currently practising in Australia. They are the largest single health profession in Australia. But more importantly, they are most often the face of care to the person needing care. And this is particularly important to remember when thinking about the care needs of an older person who may be the last stage of their life.

Many older people spend some or all of the last year of their life at home. Some will move to residential aged care or will already be in an aged care facility. Others will live with families or friends. Some may spend time in a hospital. Nearly all will be involved with a GP and with their Practice Nurses. So not only are nurses critical in enabling good care for older Australians coming to the end of their life, they will be providing this care in many different settings.
 

Health professionals can find it difficult to manage the growing evidence relevant to the care of patients with palliative care needs. While CareSearch provides access to a wide variety of palliative care evidence and resources, knowing which one to use can be tricky. Recognising when it might be worthwhile looking for additional evidence is also important. These were the original reasons why we introduced My Learning, a web-based learning initiative, in 2012.  Educational modules in My Learning introduced health professionals to resources in CareSearch and showed how they could help in clinical care and decision making. Since then, each month, around 100 people complete the learning modules.
 

The Fourth International Conference on Grey Literature (GL '99) in Washington, DC, in October 1999 defined grey literature as ‘that which is produced on all levels of government, academics, business and industry in print and electronic formats, but which is not controlled by commercial publishers’.

Grey literature can include material that is not conventionally published and may be hard to find and sometimes ephemeral. It is not indexed formally in major databases and requires general web searching using a search engine such as Google. It can include such items as government reports and documents, state-of-the art reports, market research reports, theses, conference papers, technical specifications, and standards.