MISSED OPPORTUNITIES: A QUALITATIVE STUDY OF HEART FAILURE NURSES' EXPERIENCES OF END-OF-LIFE CARE FOR HEART FAILURE PATIENTS

Background: Heart failure is a chronic, progressive condition with a high symptom burden and a high mortality rate.
Aim: To explore the experiences of Heart Failure Nurses in delivering palliative care to heart failure patients.
Method: A qualitative study using semi-structured interviews.
Findings: Three main themes emerged as: the Heart Failure Nurse role in Advance Care Planning; Challenges and barriers to the provision of Palliative Care and the positive impact of education and collaboration. Participants reflected on the shift in mindset with palliative care originally seen as outside their scope of practice to a care pathway, now integral to their role. This was underpinned by the provision of specific training, sharing of practice and growing exposure to clinical practice across settings which facilitated this process.
Conclusions: Heart Failure Nurses are in a unique position to provide Palliative Care for their patient but they highlight that current PC provision fails to meet the specific needs of HF patients at a systems level. There is an inconsistency of palliative care services across and within systems and professions attributed to both resources and lack of understanding. A collaborative model which integrates palliative care, cardiology and primary care teams is required to lead to more holistic patient care. Further research is needed to ascertain the most effective models to integrate PC in HF and assess patient and caregiver perspectives.