Updating international consensus on best practice in care of the dying: A Delphi study

Abstract

Background: Good care of the dying has been defined as being able to die in the place of your choice, free from pain, cared for with dignity and supported by the best possible care. This definition underpinned the development of the ‘10/40 Model’ of care for the dying, in 2013. The model includes 10 ‘Key Principles’ that underpin 40 ‘Core Outcomes’ of care. It was necessary to update consensus on the 10/40 Model to ensure that it remains clinically relevant and applicable for practice. Aim: Update international consensus on the content of the 10/40 Model. Design: Delphi study utilising questionnaire completion; each round informed the need for, and content of the next. Free text comments were also sought. Three rounds of Delphi were undertaken. Setting/participants: A total of 160 participants took part in round 1, representing 31 countries; 103 in round 2 and 57 in round 3. Participants included doctors, nurses, researchers and allied health professionals, with over 80% working predominantly in palliative care (general/specialist not specified). Results: Minor amendments were made to seven items related to: recognition of the dying phase, ongoing assessment of the patient’s condition, communication with patients about the plan of care and care in the immediate time after the death of a patient. Results supported the addition of a sub core outcome for care provided after death. Conclusion: The updated 10/40 Model will guide the delivery of high-quality care for dying patients regardless of the location of care. Further work should focus on increasing lay participation and participation from low income and culturally diverse countries.

Palliative and end-of-life care practices for critically ill patients and their families in a peri-intensive care setting: A protocol for an umbrella review

“…From these concepts, we will develop free-text and thesaurus terms. We also used an index paper (McGlinchey et al 2023) to broaden our search terms and identify additional free-text and thesaurus terms relevant to the scope of the review (Ramer 2005). The thesaurus terms are specific to the subject-specific databases we searched, such as MEDLINE, CINAHL, EMBASE, and PsycINFO.…”