Abstract 1282P
Background
Palliative care is delivered in specialist inpatient units, in the community and in the acute hospital. Optimizing treatment provision to a dying patient in the acute setting can be challenging. A form to provide guidance to teams in the acute hospital managing a patient at end of life has been developed. The aim of this guidance is to improve patient management at end of life and improve outcomes for the patient and their loved ones. This form was piloted on an oncology and geriatrics ward in a 600-bed acute hospital for a period of 6 weeks.
Methods
A retrospective audit was completed on the forms of patients who had died in the 6-week pilot period. Form users provided feedback on the usefulness of the form highlighting any areas for improvement they noted.
Results
There were 18 deaths in total in the 6-week period. Forms were completed for 50% of patients. The portion of the form to be completed before a patient died demonstrated significantly higher compliance (89%) compared to the portion to be completed post death (11%). 78% recorded whether death notification to the coroner was required, 67% noted that family had been advised that the patient was dying. The consideration of referral to the palliative care team was documented in 67% of forms. Only 22% noted that chaplaincy had been advised. Only 11% recorded considering bereavement support through either social work or chaplaincy referral. 11% noted that the GP had been advised of the patients’ death. User feedback was positive in relation to the use of the guidance with users finding it very helpful as a reference point in end-of-life situations.
Conclusions
Many medical teams in the acute hospital have little experience of managing a dying patient. This form provides useful guidance going forward and should improve patient and family outcomes. A 50% form completion rate indicates that more awareness of the form and its purpose is required. The lack of completion of the post death section is attributable to the removal of patient notes from wards shortly post death. This is an area which requires attention to ensure important post death support is provided to families and to ensure GPs are informed of the death of their patient in hospital. The aim is to implement this document across the hospital and potentially nationwide.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Orfhlaith Mc carthy.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.