A tertiary hospital audit of opioids and sedatives administered in the last 24 h of life

Douglas, Clint; Clarke, Melissa; Alexander, Stephanie; Khatun, Mohsina

doi:10.1111/imj.12985

Cited by 3 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recognition of dying and pathway use is more likely for patients with cancer, 15 yet the diversity in admitting specialties in this cohort suggests that recognition of dying and prognostication may not have been so obvious, potentially affecting timely recognition of dying and pathway use. Recent intense scrutiny of the Liverpool Care Pathway in the UK has meant that end-of-life care pathways have received significant negative attention, 16 possibly affecting clinician perceptions of their utility.…”

Section: Element 3: Goals Of Carementioning

confidence: 92%

End-of-life care in hospital: an audit of care against Australian national guidelines

2019

View full text Add to dashboard Cite

Objective. The aim of this study was to map end-of-life care in acute hospital settings against Elements 1-5 of the Australian Commission on Safety and Quality in Health Care's (ACSQHC) Essential Elements for Safe and High-Quality End-of-Life Care.Methods. A retrospective medical record audit of deceased in-patients was conducted from 2016 at one public (n = 320) and one private (n = 132) hospital in Melbourne, Australia. Ten variables, key to end-of-life care according to the ACSQHC's Elements 1-5 were used to evaluate end-of-life care.Results. Most patients (87.2%) had a limitation of medical treatment. In 91.97% (P < 0.0001) of cases, a written entry indicating poor prognosis preceded a documented decision to provide end-of-life care, with a documented decision noted in 81.1% of cases (P < 0.0001). Evidence of pastoral care involvement was found in 41.6% of cases (P < 0.0001), with only 33.1% of non-palliative care patients referred to specialist palliative care personnel (P = 0.059). An end-of-life care pathway was used in 51.1% of cases (P < 0.0001).Conclusion. There is clear scope for improvement in end-of-life care provision. Health services need to mandate and operationalise Elements 1-5 of the ACSQHC's Essential Elements into care systems and processes, and ensure nationally consistent, high-quality end-of-life care.What is known about the topic? Acute care settings provide the majority of end-of-life care. Despite the ACSQHC's Ten Essential Elements, little is known about whether current end-of-life care practices align with recommendations. What does this paper add? There is room for improvement in providing patient-centred care, increasing family involvement and teamwork, describing and enacting goals of care and using triggers to prompt care. Differences between public and private hospitals may be the result of differences in standard practice or policy and differences in cultural diversity. What are the implications for practitioners? The Essential Elements need to be mandated and operationalised into mainstream care systems and processes as a way of ensuring safe and high-quality end-of-life care.acute hospitals provide the majority of end-of-life care, 2,4 with 80 000 people per year dying in hospital. 3 Measuring the quality of end-of-life care is essential. A recent Australian study sought to determine the gap between issues defined as important by people approaching the end of life and 'usual care' in general wards across two tertiary referral Journal compilation Ó AHHA

show abstract

Section: Element 3: Goals Of Carementioning

confidence: 92%

End-of-life care in hospital: an audit of care against Australian national guidelines

2019

View full text Add to dashboard Cite

show abstract

“…Articles written for hospitals or lay press are inevitably edited to remove any direct mention of ‘dying’. This issue was highlighted recently, when attempts were made to edit an article for this journal on death in a major metropolitan hospital by replacing the words ‘died’ and ‘dying’ with ‘expired’ and ‘terminally ill’.…”

mentioning

confidence: 99%

Pining for the fjords¹

Hardy

Douglas

2016

Internal Medicine Journal

View full text Add to dashboard Cite

Language Used by Health Care Professionals to Describe Dying at an Acute Care Hospital

Wentlandt

Toupin

Novosedlik

et al. 2018

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

show abstract

A tertiary hospital audit of opioids and sedatives administered in the last 24 h of life

Abstract: The significance of the lower midazolam doses was postulated, including the possibility of inadequate symptom control for patients with a non-malignant diagnosis. The use of the mLCP did not lead to the provision of higher doses of medications.

Cited by 3 publications

References 11 publications

End-of-life care in hospital: an audit of care against Australian national guidelines

End-of-life care in hospital: an audit of care against Australian national guidelines

Pining for the fjords¹

Language Used by Health Care Professionals to Describe Dying at an Acute Care Hospital

Contact Info

Product

Resources

About

A tertiary hospital audit of opioids and sedatives administered in the last 24 h of life

Abstract: The significance of the lower midazolam doses was postulated, including the possibility of inadequate symptom control for patients with a non-malignant diagnosis. The use of the mLCP did not lead to the provision of higher doses of medications.

Cited by 3 publications

References 11 publications

End-of-life care in hospital: an audit of care against Australian national guidelines

End-of-life care in hospital: an audit of care against Australian national guidelines

Pining for the fjords1

Language Used by Health Care Professionals to Describe Dying at an Acute Care Hospital

Contact Info

Product

Resources

About

Pining for the fjords¹