Use of the interRAI palliative care (PC) instrument: An active mediation role for PC nurses in their professional experience

AimsTo study the impact and contribution of using a comprehensive needs assessment tool (InterRAI PC) to the professional experience of PC nurses.MethodsA qualitative design was used; we held four focus groups comprised thirty nurses from PC 25 settings across France, all were involved in the process of using InterRAI PC. Qualitative content analysis, supported by QDA Miner, was conducted by 2 researchers who agreed on a final thematic tree. Guba's model was used to support our attention to ensure trustworthiness of the study.ResultsFor the nurses, the InterRAI PC played the role of mediation at four levels. First, its use allowed to release the free speech and to open the relationship space between caregivers, patients and relatives; second, it helped to frame the evaluation and encouraged the nurses to take a specific assessment time which is appreciated and rewarding for the patients; third, it has provided an effective mechanism for supporting the nurses' reflexivity on their clinical practice; finally, the data collected by this instrument objectified the assessment carried out by nurses and contributed to the positive reinforcement of professional identity all the while questioning their clinical and evaluative skills. Furthermore, the deep comprehensive assessment could be source of tension and guilt for the nurses unable to address effectively the patient's needs.ConclusionsThe use of patients' needs assessment tools in PC can have several effects on clinical practice other than to identify patients' needs, it also has an impact on the professionals' and patients' experience. Future studies should be interested, not only with the validity and the reliability of the assessment tools, but also with the impact of their use as perceived by stakeholders.