A Scoping Review of the Barriers and Facilitators to Clinician Engagement in Hospital-Based Palliative Care in Australian Hospitals.
Edward Meehan, Catriona Parker, Darshini Ayton and 6 others
PMID 39352735WHAT IT FOUND
Barriers to timely hospital palliative care referral in Australia included patient and family reluctance, clinician uncertainty about prognosis, preference for curative treatment, poor access, and weak communication with palliative care teams.
Nurses can use these themes to spot referral barriers.
Key findings
01The review categorized barriers and facilitators to inpatient palliative care into seven domains.
02Patients often believed palliative care was appropriate only for terminal or near terminal care and that referral meant no further formal medical treatment was available.
03Multidisciplinary team meetings were reported to improve visibility of the palliative care team and facilitate referral pathways with hospital staff.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a scoping review, so it mapped themes but did not estimate how common each barrier or facilitator is in Australian hospitals. The included studies used different designs and question sets, so their findings could not be compared directly across hospitals. Qualitative studies were limited by specialized contexts and often did not address local resource deficits. Quantitative studies mainly examined referral timing and patient demographics, not the complexity of multidisciplinary factors. Most studies were from Australia's three most populous states, so other states and territories may be underrepresented.
The easy way to misread this
Do not read the reported domains as evidence that any intervention improves palliative care uptake or patient outcomes. This review summarized reported barriers and facilitators; it did not test them or estimate prevalence.