Download - Palliative Care Australia

PROGRAM OF EXPERIENCE
IN THE PALLIATIVE
APPROACH (PEPA)
The Program of Experience in the Palliative Approach (PEPA)
is an initiative of the Australian Government Department
of Health and Ageing’s National Palliative Care Program.
PEPA aims to improve the quality, availability and access to
palliative care for people who are dying and their families.
To achieve this aim, PEPA provides workforce placements
and structured learning experiences to develop the capacity
of health care professionals to deliver a palliative care
approach.
PEPA has been developed and implemented in two parts.
PEPA 1 commenced in 2003 and provides placements for nurses
and allied health professionals from primary health settings
within specialist palliative care services to gain knowledge,
skills and experience in the palliative approach to care. PEPA
2 commenced in 2005 and involves: (a) clinical placements
with specialist palliative care services and structured learning
experiences for GPs and rural and remote medical officers,
and (b) clinical placements for specialist palliative care staff
to develop skills in selected medical specialities.
Over 750 health care practitioners, one-third from rural
settings, have gained knowledge, skills and experience by
completing a PEPA placement.
PEPA is being evaluated using pre and post-placement
participant, employer and palliative care host site surveys.
Interviews are also being conducted with a sample of
participants, employers and host site personnel to collect indepth
descriptive data. To date, respondents to the evaluation
have reported increased confidence in caring for people with
life limiting illness. This enhanced confidence is related to
participants’ perceived improved assessment skills, abilities
to identify and implement interventions and abilities to
communicate with patients, and the formation of links with a
specialist palliative care service if assistance is required. For
example, one participant has commented that:
‘(I am) more confident to discuss issues with the family and
doctor attending to the client…’ and have ‘more contacts
to access necessary information about care and other
resources.’
The formation of links between primary health care providers
and specialist palliative care services is an important
component of PEPA. Participants have indicated that ongoing
contact with the host site has assisted their practice in areas
such as the management of complex clinical and psychosocial
issues. Some host sites have reported that the networks
formed with primary care providers have enhanced referral
pathways and assisted them to gain an insight into the
issues that the primary health providers face. The following
responses from participants provide examples of host site
assistance following the placement:
• We asked the palliative care team to review a resident
who had difficult pain relief problems. They gave us both
support and advice to enhance care delivery.
• Client in end stage motor neurone disease - assistance and
advice regarding management at home now that client
can’t self care anymore (gave advice about) equipment and
carer support.
Other examples provided suggest PEPA is achieving its
goals in terms of enhancing the capacity of primary health
care providers to provide a palliative approach to care. For
example, respondents have reported:
• Open discussions with staff, residents, family and GPs (on)
how to treat residents with life limiting illness. When a
resident had been admitted to hospital we were told that
this person had not long to live. With the assistance of
the palliative care consultant in the hospital and from the
community we were able to have this resident cared for in
her own room and surrounded by the people she loved.
Since the PEPA program we have had two cases like this
and it has been a great experience for the staff, the residents
and the families.
• Improved competence with use of pain relieving medication
– this has also been helpful in managing non-malignant pain
arthritis and osteoporotic fractures. Able to avoid referral to
hospital emergency department.
Further information on PEPA is available at
www.pepaeducation.com
PCA Staff
PCA’s team consists of (left to right): Nicky Reavell, Project
Officer; Catherine Kennedy, National Office Manager; Anna
Picker, Project Officer, Karen Cooper, Project Manager,
Donna Daniell, Acting Executive Director, Cindee
Richardson, Project Manager; Dylan Malloch, Marketing
and Communications Officer; Camilla Rowland, National
Projects Manager; Fiona Couchman, Policy Officer; Stephanie
Bradford, Administrative Assistant.
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