The development of medication management practice guidelines for nurses working with palliative care clients

Hanan Khalil, Jo Parr, Susan Waller

Research output: Chapter in Book/Report/Conference proceedingConference PaperResearchpeer-review


Aims: To develop a medication management practice guideline to support quality care for rural clients and nurses in the community with a focus on palliative care.
Methods: The development of the guidelines included a sequential mixed methods design which involved the following steps; 1 gathering of vignettes from practice situations, 2. an Interprofessional collaboration forum, 3. literature review and draft guidelines prepared by the project team based on the literature, 4. an online survey for community and district nursing working in rural areas, 5. Semistructured interviews with rural general practitioners, pharmacists and consumers and/or their carers,6. Revision of the guidelines based on findings from the surveys and the interviews, 7.Revision of the guidelines based on stakeholders opinions and obtaining endorsement of guidelines by key local organisations.
Results: The guidelines were developed for nursing staff involved in caring for adult clients who received palliative care in rural areas. A total of 13 principles underpinning the guidelines with an explanation of what each principle were included. The main principles were; information resources,medication administration, medication orders and supply, syringe drivers, dose administration aids,medication storage, medication disposal, risk management and adverse events, transport of medications and cytotoxic medication administration.The establishment of the guidelines led to a few recommendations to positively change the activities of the organisations regarding medications management. Examples of these recommendations were creating online educational resources addressing specific aspects of medications administration such as syringe drivers and cytotoxic medication handling and disposal.
Relevance: Rural community and district nursing practices form an integral part of delivering health services to palliative care clients. Provision of palliative care in the rural community has its unique challenges such as; varying perceptions of palliative care, professional issues and challenges of providing care in the community and system barriers. Medication administration is a key responsibility of community nursing staff assisting palliative care clients in their home. However, there is lack of clarity around their roles and obligations in the Australian rural context. Specific issues such as medication administration roles and responsibilities, medication disposal and ensuring accurate records of clients are not clearly defined by health service organisations. The formation of these guidelines addressed those needs.
Conclusion: Engaging multiple stakeholders in the rural community to draft the proposed medication guidelines resulted in identifying the scope of the proposed guideline. The development of these guidelines has the potential to promote the quality use of medicines in the rural community.Community health organisations require development of policy and procedure to support the implementation of the guidelines
Original languageEnglish
Title of host publication14th National Rural Health Conference Proceedings
EditorsLeanne Coleman
Place of PublicationCanberra, ACT
PublisherNational Rural Health Alliance
Number of pages8
Publication statusPublished - 2017
EventNational Rural Health Conference 2017 - Cairns, Australia
Duration: 26 Apr 201729 Apr 2017
Conference number: 14th


ConferenceNational Rural Health Conference 2017
Internet address

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