To develop a step by step guide to giving best care, from recognition that a patient is dying to transfer of a body to the mortuary. It would be the standard reference for all medical nursing and administrative staff involved in any in patient area: A&E, Ward or ITU.

3

A focus group (Palliative Care Consultants, Care of the Elderly

Consultants, Junior Doctors, Nurses, Chaplaincy Team and

Mortuary Staff) reviewed recent national directives regarding

gold standard care – One Chance to get it Right1, Guidance for

staff responsible for care after death2, and pre-existing Trust

wide policies regarding EOLC and care after death. The group

discussed the essential elements of care and guidance needed

by staff until consensus was reached for each element to be

included in the final resource.

The essential building blocks to providing excellent care were

agreed and distilled into Step 1- 8 for Care of Dying Person,

and Steps 9 - 19 for Care and Respect After Death. Both

sections contain clinical guidance, information support,

Patient Information Leaflets (PIL) and administrative protocols

(Table 1).

In a busy general hospital end of life care (EOLC) can be fragmented & of variable quality. Generic health care professionals need simple, accessible & practical advice regarding how to ensure best comprehensive care.

*Based on the Priorities of Care of the Dying Person, this includes

recognition of dying, ceilings of care, explicit plans regarding food and

drink, symptom control and anticipatory prescribing, patients and carer

involvement and communication.

The guide has been compiled into large, purple and white

Resource Folders that are clearly visible at each nursing

station in each inpatient area. The front cover states the in

and out of hours contact details for Specialist Palliative

care advice. It is the standard reference for care of all

patients, and the focus of teaching on Trust Induction

Training.

Volunteers from the Hospital Macmillan Information Centre

hold copies of all documents in the resource folder and

replenish items on a regular basis.

Funding requirements – Resource Folders paid for

through Hospital Palliative Care Department Charitable

Fund.

A Step by Step Guide to Great End of Life Care: a

multidisciplinary resource for use in all inpatient

settings

AIM 2

METHODS

CONCLUSION 5

1 BACKGROUND

RESULTS 4

Table 1: Elements Of Guidance in Resource Folder

Figure 1. Generic and Specialist Palliative Care Staff of

all grades refer the resource folder

REFERENCES

1One Chance to Get it Right 2014

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/32

3188/One_chance_to_get_it_right.pdf 2Guidance for staff responsible for care after death 2014

http://www.nhsiq.nhs.uk/media/2426968/care_after_death___guidance.pdf

Potter, J., Saunders, Y., Bunker, L. The Hillingdon Hospital NHS Foundation Trust

Section Clinical guidance Information support

Administrative protocols

Care for the Dying Person

How to create an Individualised Care Plan for Excellent Care at the End of Life* How to set up a syringe driver Mini guidelines on symptom control

What to expect when someone is dying PIL Tissue donation PIL Chaplaincy team contact details

How to complete Individualised Care Plan

Care & Respect after Death

How to verify death When to refer to a Coroner Pictorial guide to undertaking Last Offices

Bereavement PIL Chaplaincy team contact details

Mortuary Infection Control notification Cancellation of future hospital appointments