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Poster Numbers 185 – 241 – People & places: Poster No: 230
Audit of LCP anticipatory medicine prescribing at a large teaching hospital
  1. Jen Dyer and
  2. Andrew Dickman
  1. Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK

Abstract

Introduction The (LCP) is a programme within the Marie Curie Palliative Care Institute Liverpool (MCPCIL) portfolio and should be undertaken and managed by a multi-disciplinary team. It is an integral part of the End of Life Care Strategy. The aim of the LCP is to ensure that all dying patients, and their relatives and carers, receive a high standard of care in the last hours and days of life. The LCP template can be adjusted to enable the creation of local guidelines for use within a clinical setting. The LCP incorporates treatment algorithms for five of the most common symptoms experienced by the dying patient that is, pain, agitation, respiratory tract secretions, nausea/vomiting and dyspnoea. The algorithms stipulate that anticipatory medicines should be prescribed pro re nata (PRN) in case these symptoms develop and to avoid unnecessary delay in their treatment.

Aim and Objective To assess the current level of LCP anticipatory medicine prescribing compared to local Trust guidelines and identify any potential training needs.

Method This retrospective audit was performed over a period of 1 month, with a total of 32 patient records being identified.

Results Only 37.5% (12/32) inpatient charts adhered to the Trust's LCP guidelines. The remainder contained one or more prescribing errors (n=53 identified). The most common error identified (68%) was omission of one or more of the anticipatory medicines. Confusion as to which opioid to prescribe was also evident; diamorphine is presently the first-line choice.

Discussion and Conclusion This audit showed that 62.5% of LCP anticipatory medicine prescribing was non-compliant with Trust guidelines. Additional training needs have been identified and a programme of education and training can be developed. Once this has been established, the inpatient charts should then be re-audited to check for improvement and compliance.

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