Using the Liverpool Care Pathway for a dying patient

Abstract

This article describes the experience of staff in one acute hospital in Northern Ireland who adapted the Liverpool Care Pathway (LCP) for the dying patient to suit their organisation. It focuses on one patient's journey, from diagnosis to terminal care. The patient remained on the care pathway for 12 days. This reflection demonstrates that, as long as patients continue to meet the criteria for the LCP, some may be on the care pathway for more than the recognised average of two days.

End-of-life care pathways and nursing: a literature review

“…It is evident from reviewing existing literature that nurses have engaged in EOLC pathway development, either as members of quality improvement teams (Bookbinder al. 2005al. , McNicholl et al 2006, multidisciplinary committees, steering groups and working parties (Pooler et al 2003, Luhrs et al 2005, Mirando et al 2005, Jackson et al 2009, Lo et al 2009 or as specialist palliative care practitioners (Lhussier et al 2007).…”

“…Effective EOLC pathway implementation is contingent on a practitioner-led, strategic approach in which a supportive space is created, enabling the voices of those who will use pathways to be heard. Analysis of the literature revealed that several small scale, international studies, audits and anecdotal accounts have described, in various detail, EOLC pathway implementation for various conditions and in different care settings (Fowell et al 2002, Jack et al 2004, Luhrs et al 2005, McNicholl et al 2006). Frequently quality improvement methodologies were advocated and have been used to facilitate EOLC pathway implementation (Ellershaw et al 1997, Bookbinder et al 2005.…”

Information management and quality of palliative care in general practices: Secondary analysis of a UK study

“…It is usually only used in the patient's last few days and ensures that the whole team record their notes in one place and gives guidance for continuing assessment of the patient [22]. The effect of the LCP in the Netherlands has been studied and was found to improve documentation and that, with symptoms also controlled better, it improved care for people who were dying [23].…”

What is the alternative to persistent therapy? The English proposal for standardized procedures applied in the last hours of the oncological patient’s life

“…LCP is a protocol dealing with the last moments (about 48 hours, in some modifications up to even 12 days) of the patient's life [4,19]. It only requires from the medical professionals ticking the right option on the form or choosing one out of two one-letter codes.…”

“…The needs of both the patient and his family are included. Limiting the number of unnecessary and painful medical procedures was the goal [1][2][3][4][5]. Protocols resembling the LCP have been in use in the British health care system for years, facilitating work and eliminating the personnel's mistakes [1].…”