PILOT OF AN END-OF-LIFE CARE PATHWAY IN NON-CANCER PALLIATIVE UNIT IN CHINESE POPULATION
Background The End-of-life Care Pathway (ECP) based on the concept used in Liverpool Care Pathway (LCP V.12), was developed, with modification to suit the local needs. It was first applied to non-cancer palliative unit (MPM) in Hong Kong.
Objective To identify the quality of care for dying patients as documented in ECP and benchmark our performance with the National Care of the Dying Audit—Hospital (NCDAH) 2009 in UK.
Methods A retrospective audit design was used to gather ECP data from Tuen Mun Hospital from 1st August to 31st December 2010.
Results 117 deaths occurred in the audit period and 42 ECP was applied. Median Age is 80 (IQR=75–85); 55% are female; 79% are non-cancer patients. The most common diagnosis is end-stage renal failure. The median duration in ECP is 62 h (IQR=18–103). A high percentage of patients and carers can participate in the communication (95.4%, 95.2%), aware the dying status (88.9%, 90.5%), have the current interventions reviewed (100%), and symptoms controlled (range from 85.1% to 90.5%).
Relatively low percentage of the patients and cares could discuss about their spiritual needs (77.3%, 78.6%), have the anticipated symptoms control medications prescribed and received (71.4%, 36.7%), pathway explained (83.3%, 54.8%) and physically adjusted environment received (76.2%). The comparison of the results with the NCDAH 2009 was shown in table 1.
Conclusion This audit point out different aspects for improvement of the ECP first applied in non-cancer medical unit in Hong Kong
- Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions