Authors (including presenting author) :
Kong TYK (1), Kwong MC (1), Law TL (1), Lai BK (1), Ng LY (1)
Affiliation :
(1) Palliative Care Team, Central Nursing Division, Queen Elizabeth Hospital, Hospital Authority, Hong Kong
Keyword 1: :
Palliative care
Keyword 2: :
Nursing competence
Keyword 3: :
End-of-life communication
Keyword 4: :
Value-based care
Keyword 5: :
Training program
Keyword 6: :
Person-centred care
Introduction :
Palliative care is increasingly recognized as integral to acute hospital practice as patients with life limiting diseases often transition from curative treatment to comfort focused care during hospital admissions. International and local studies show that non specialist clinicians, including those in Hong Kong hospitals, frequently report limited formal training and low confidence in managing complex symptoms, conducting end of life discussions, and providing comprehensive, value based care. In particular, staff have highlighted inadequate preparation for counselling, psychosocial support, and navigating ethical and cultural issues surrounding death and dying. (Selman, L.,2015). This training gap is critical for nurses working in acute wards who regularly care for patients with advanced, life limiting conditions yet may have only general palliative care knowledge. (Lee, C. N., 2025). To address these needs, the QEH Palliative Care Nursing team designed a 2 day Palliative Care Induction Program (clinical attachment) to immerse nurses in the team’s philosophy, assessment processes, communication strategies, and bedside nursing practice, with the goal of promoting sustainable competence transfer and nurturing a shared person-centred, dignity preserving culture across the hospital.
Objectives :
-To strengthen the competency of QEH nursing staff through attachment and skill transfer to improve the care of patients with life-limiting disease -To facilitate the service coordination with PC teams -To build up strength for communication skills especially for End-of-life patients and families -To facilitate better care delivery during care transition period from curative to palliative care
Methodology :
Pre-post evaluation using the Nurse Professional Competence (NPC) Scale© (35 items, 1–6 scale, 6 domains). Participants included 22 QEH nurses (9 APNs, 13 RNs) with 3–27 years' experience (mean ≈10 years) from Clinical Oncology, Medical, Surgical, ICU, Orthopaedics, AED and Ventilator ward. The 2-day program comprised palliative care principles, holistic assessments, ward rounds (Day 1) and Communication skill training, including ACP discussion, family support and dignity-preserving care (Day 2).
Result & Outcome :
Overall NPC improved from 2.65 to 3.82 (+1.17), shifting to "high degree" competence. Largest gains are Care Pedagogics from 2.45 to 3.68 (+1.23), Value-based from 2.58 to 3.80 (+1.22) and Nursing Care from 2.65 to 3.82 (+1.17). The three competence domains demonstrated consistent improvements. Reflective themes across 3 core domains confirm quantitative gains. Care Pedagogics (+1.23) through empathic DNACPR, disease trajectory discussions and cultural sensitivity ("Deep talk builds rapport"). For Value-based Nursing Care (+1.22) emphasizes "right care" philosophy and spiritual integration ("Stand with families"). For Nursing Care (+1.17) via holistic assessment (Palliative Performance Scale and disease trajectories), symptom control (by subcutaneous infusion of opioids), and dignity care ("Dignity as important as pain control"). The program outcomes demonstrate enhanced conversations that reduce miscommunication, earlier symptom management that improves family satisfaction, and a person-centred culture that deepens ethical End-of-life care. Conclusion The 2-day Palliative Care Induction Program successfully met all objectives, achieving substantial improvements across all six NPC domains (largest gains: Care Pedagogics, Nursing Care and Value-based Nursing Care). The overall NPC improvement of approximately increased 1.17, which demonstrates the program's effectiveness in strengthening nursing competence, improving multidisciplinary collaboration, enhancing End-of-life communication skills, and facilitating smoother transitions from curative to palliative care.
