Evolving A Sustainable Model of Guidance to Support Individual Care of Dying Patients: A National Perspective.
This paper details the evolution of guidance to support care in the last days of life in Wales, incorporating
strengths of previous work and utilising the impetus provided by the national
debate on end-of-life care.
It explains the function of a centralised data
collection, analysis and feedback system, outlines the current
implementation and future evaluation and sustainability.
Superseding existing end-of-life care systems with new guidance
has implications for practice and policy: A centralised quality
monitoring system supports
effective changeover from existing system to new guidance.
Through the process of continual quality monitoring,
annual audit and review, the guidance can be kept dynamic and
flexible to meet the needs of the individual patient, those
important to them and the HCPs delivering care.
Structured documentation provides a tangible way of
evidencing the implementation of
national guidance to support care in the last days of
life. It enables clinical teams to demonstrate working to
guidance grounded in evidence where available and best accepted care.
The Care Decisions guidance is comprised of four sides of A4 print, the Case
Review Sheet and additional resources as
described above. In total, this results in seven
documents including the ‘as needed’ medication prescription sheet, continuous subcutaneous infusion medication administration record and check chart.
There is a question about whether the documents would
be best suited as a ‘one-click delivers all’ particularly in a busy care setting whereby the additional supporting documents may be overlooked.
Palliat Med Hosp Care Open J. 2017; 3(2): 26-31. doi: 10.17140/PMHCOJ-3-124
