Abstract

This study was of a qualitative design and consisted of semi-structured interviews of nursing and medical staff in a district general hospital in the northwest of England. The interviews were transcribed verbatim and then thematic analysis was then used to explore emerging themes.

16 interviews took place of non-palliative care staff of all grades and disciplines. Seven nurses and nine doctors were interviewed. Emergent themes were that the pathway is used across all the disciplines that took part with wide use in non-cancer patients. Participants generally felt that the pathway had a positive impact in care of the dying. Perceived barriers included difficulty in diagnosing dying and the review/discontinuation of unnecessary interventions. The amount of training in use of the pathway that participants had had was extremely varied.

Although, the pathway has a perceived positive impact in this acute hospital setting, there are still barriers to its use and variability in confidence and knowledge of those involved in it's use. It would appear that there is a need for mandatory training for health professionals involved in the care of dying patients and the ongoing support of a pathway coordinator.

As a result of this study and other work that has taken place, as well as having an end of life coordinator for the whole hospital, there is now going to be a nominated end of life team from each ward.