Evaluating a palliative care education project in nursing homes.

This article reports on an evaluation of a 2-year palliative care education project for nursing home staff. The aim of the project was to provide education for all levels of nursing home staff so that the care of dying residents could be improved. In order to ascertain the outcomes of the initiative two approaches to data collection were adopted. Case studies of four participating nursing homes were undertaken, involving a period of participant observation and interviews with staff members. A postal survey of the participating nursing homes and non-participating nursing homes from the same geographical region was also carried out. The impact of the project is described, identifying how the care of residents and their relatives was affected, the differing impact on the participating staff groups and the degree to which the organizational practices of the nursing homes changed. Although the project influenced course members' practice, the provision of courses such as these was recognized to be insufficient to ensure widespread organizational changes. Questions regarding the effectiveness of education as an agent of organizational change were raised throughout the project and the evaluation.