Best practice for care in the last days of life

Murphy, Deborah; Bolger, Maria; Agar, Ruth

doi:10.1108/13663666200700047

Cited by 6 publications

(9 citation statements)

References 2 publications

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“…2007, Department of Health, 2009). This is despite findings from a study by Murphy et al. (2007), which reported that when asked the majority of people stated that their preference was to die at home, rather than in hospital.…”

Section: Introductionmentioning

confidence: 63%

“…After these initial retrievals were undertaken and from reading the literature retrieved, it became clear it was impossible to explore EOL care in acute hospitals without giving consideration to the Liverpool care pathway (LCP). The LCP was developed in the UK from a collaboration between a hospital‐based palliative care team and the Marie Curie Hospice Liverpool to assist in transfer of the best practice model of care of the dying patient from the hospice setting to the acute setting (Murphy et al. 2007).…”

Section: Methodsmentioning

confidence: 99%

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End-of-life care in acute hospitals: an integrative literature review

Bloomer¹,

Moss²,

Cross³

2011

Journal of Nursing and Healthcare of Chronic Illness

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End-of-life care in acute hospitals: an integrative literature review Aim. To explore and define the current status of published literature related to endof-life care in the acute hospital setting. Background. Chronic illness is now the leading cause of death in developed countries because the population is and the advances in health care delivery. In Australia, two-third of people with chronic illness who die is inpatient in an acute hospital. Whilst most of the attention regarding end-of-life care and dying has focused on palliative care settings, there is a need to consider those dying outside of specialist palliative care settings. Design. Integrative literature review. Methods. Using an integrative approach, electronic searches of selected databases were undertaken, using comprehensive search terms. Secondary sources were also identified through the reference lists of retrieved literature. Results. The literature review identified a lack of high-quality scientific evidence to direct end-of-life care as delivered in the acute (non-palliative care) sector. From the literature available, five core themes/issues were generated to reflect the literature. Conclusions. There is a need for research to investigate end-of-life care in the acute hospital setting. Care pathways are in use to varying degrees without validation, but implementation alone does not ensure quality end-of-life care. Cultural factors can impede/impact practice and the ability of clinicians to recognise 'active dying' has been shown to be problematic, delaying the transition to end-of-life care. Relevance to clinical practice. Given that the majority of deaths in Australia occur in acute hospital settings, clinicians should be delivering expert life-sustaining acute care and also quality end-of-life care.

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Section: Introductionmentioning

confidence: 63%

Section: Methodsmentioning

confidence: 99%

End-of-life care in acute hospitals: an integrative literature review

Bloomer¹,

Moss²,

Cross³

2011

Journal of Nursing and Healthcare of Chronic Illness

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“…The necessity for thoughtful utilization of the LCP in relation to clinical skill has been clearly articulated. 36 To achieve this collaboration with specialist palliative care services is recommended.…”

Section: Discussionmentioning

confidence: 99%

Staff Perceptions of End-of-Life Care following Implementation of the Liverpool Care Pathway for the Dying Patient in the Acute Care Setting: A New Zealand Perspective

Clark

Sheward

Marshall³

et al. 2012

Journal of Palliative Medicine

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“…The literature also highlights that clinicians have difficulty in diagnosing dying, or recognizing that the patient has entered into the dying phase (Verbeek et al ., 2006; Pugh et al ., 2010; Bloomer et al ., 2011), a situation that further compounds the delivery of inappropriate care for dying patients in the acute hospital setting. There is also considerable evidence that care pathways, such as the Liverpool Care Pathway, have contributed to the improvement of clinical care for the dying, and resulted in increased staff satisfaction (Jack et al ., 2003; Murphy et al ., 2007; Ingleton et al ., 2009); however, a number of questions still remain unanswered; for example, how nurses identify patients as dying, how they respond to them, and how they care for the patient and family.…”

Section: Background: Qualitative Studies In End‐of‐life Carementioning

confidence: 99%

Qualitative observation in a clinical setting: Challenges at end of life

Bloomer

Cross

Endacott

et al. 2012

Nursing & Health Sciences

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This paper explores the methodological challenges associated with undertaking qualitative observation in the clinical setting at end of life. The authors reflect on their experiences of using non-participant observation to explore the nursing care delivered to dying patients in acute hospital wards. The challenges of observation as a method, clearly defining the participant group and involving vulnerable populations, such as the dying patients and their families, will be discussed. Consideration is also given to defining and working within the observational field, the researchers' dual roles, cost versus benefit, impact of culture, religion and ethnicity, and the determination of research limits/boundaries, with reflections from the authors' own experiences used to exemplify the issues.

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Best practice for care in the last days of life

Cited by 6 publications

References 2 publications

End-of-life care in acute hospitals: an integrative literature review

End-of-life care in acute hospitals: an integrative literature review

Staff Perceptions of End-of-Life Care following Implementation of the Liverpool Care Pathway for the Dying Patient in the Acute Care Setting: A New Zealand Perspective

Qualitative observation in a clinical setting: Challenges at end of life

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