Better palliative care for residents of inpatient nursing homes through qualification of nursing staff - a cluster randomised study.

Authors

Franziska Radicke, Laura Rehner-Stegen, Heiko Krause, Britta Buchhold, Dennis Nonnenberg, Janina Sarah Dombrowski, Wolfgang Hoffmann, Neeltje van den Berg

Published in

BMC palliative care. Jul 11, 2026. Epub Jul 11, 2026.

Abstract

In Germany, 80-90% of people require palliative care in the final stages of life. Inpatient care facilities are increasingly becoming the final place of residence for many people, and therefore also often their place of death. Inadequate identification of palliative care needs can result in substandard palliative care in nursing homes, where residents are often admitted to the hospital towards the end of their lives. This study investigated whether a special palliative care qualifications for nursing staff could improve the care for residents in inpatient care facilities.
A cluster-randomised intervention study was conducted. Nursing staff from the participating care facilities in the intervention group took part in the 40-hour 'Palliative Care - Multiprofessional' basic qualification course. The outcomes were the use of specialised outpatient palliative care, and the documentation of palliative-relevant symptoms and measures for residents in the three months prior to their death. Data from the patient records were assessed and statistically analysed.
During the observation period, 119 residents deceased in the 10 participating nursing homes (5 of which were in the intervention group), of whom 42 were in the intervention group and 77 were in the control group. Specialised outpatient palliative care was documented for 19.0% of residents in the intervention group and 9.1% of residents in the control group. Pain was documented in 57.1% of residents in the intervention group versus 49.4% in the control group. This palliative symptom was documented 225 times in total. An appropriate subsequent measure was documented in 150 cases (73.6% in the intervention group versus 61.9% in the control group). Logistic multilevel analysis showed that residents in the intervention group were more likely to receive a measure for a documented pain event (OR 1.804).
The results show that having a qualification in palliative care leads to palliative symptoms being identified more accurately and appropriate measures being implemented more effectively. Using data from real healthcare settings is challenging because there are no overall standards. Nevertheless, the results reflect real healthcare practice. Advanced training in palliative care helps improves the care provided to palliative residents in nursing homes. Trained staff can help to identify the need for care more accurately and ensure that appropriate palliative care is provided.
German Clinical Trials Register, DRKS00020749 (https://drks.de/search/en/trial/DRKS00020749/entails), 7 May 2020.

PMID:
42436458
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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