Background and introduction The findings of the enquiry into events at the Gosport Hospital, published in June 2018, demonstrated shocking misuse of opioid and benzodiazepine medications and syringe drivers leading to the shortening of many lives. Hospices frequently utilise opioid and benzodiazepine medications, including via syringe driver, and need to be able to demonstrate that their practice is safe and appropriate.
Methods Individual hospice units developed their own responses to the Gosport report. Both Prince of Wales and St Catherine’s Hospice undertook retrospective audits of hospice inpatient unit care. St Catherine’s Hospice presented their work for discussion at the regional ‘Learning group’ meeting.
Results The two sites utilised different collection proforma and reviewed care given to 93 hospice inpatient unit patients, demonstrating safe and appropriate practice at both hospices. Anticipatory prescribing was personalised to the patient, considering factors such as renal function, and was judged ‘appropriate’ in 82–100% of cases. 80 patients died and, as anticipated, there was significant use of opioids, benzodiazepines and syringe drivers. The use of opioids and syringe drivers was found to be proportionate and appropriate. Areas for improvement included recording of indication for both prescription and administration of medications. Through discussion of these results, it was acknowledged that a regional approach to auditing to allow ‘benchmarking’ between Hospice units would be advantageous in standard setting and comparison. Both pilot proformas had strengths and weaknesses and are being utilised to develop a regional audit proforma with plans to establish regular audit and re-audit cycles.
Conclusions As specialists with a high use of opioid and benzodiazepine medications, there is a need to demonstrate that our use of these medications is safe, consistent and of exemplary standard. The hope is that this approach will allow identification of any areas of difference in practice and offer quality assurance across region and Hospice.
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