Background This project analysed the Integrated Palliative Outcome Scale (IPOS) in a 20-bedded in-patient unit during the COVID-19 Pandemic. The scores were taken at admission, at change in Phase of Illness and at point of discharge or death. These scores were used to monitor symptom progression and effectiveness of management during the COVID-19 pandemic.
Methods The Electronic patient record (EPR) identified 110 hospice inpatients, from a total 141 admissions between 1st October 2020 – 31st March 2021) who had at least one IPOS recorded. Initial and subsequent IPOS scores were inputted and analysed in Microsoft Excel and baseline symptom prevalence and outcome measures reported (bar charts and radar plots).
Results Over the 6-month period analysed 93% of patients admitted had a primary cancer diagnosis and 7% non-cancer related conditions. The worst rated physical symptoms on admission included; weakness (2.67), poor mobility (2.59) and poor appetite (2.27). Family worry was the top score of all the domains with an average initial admission score of 3.13, this is not unsurprising, and likely that the visiting restrictions in place will be contributing to this domain All physical symptoms were successfully reduced from start to end of admission except for impact of drowsiness. The greatest reductions in average scores of the physical domains were seen for constipation (28.6%), Nausea (23.9%) and Weakness (17.2%). However, average scores for anxiety, depression and sharing feelings rose by 2.3%, 10.5% and 5.7% during the admission.
Conclusions This work confirms that an in-patient unit can collect and analyse patient outcomes data, even during a pandemic. The results demonstrate the positive impact that admission to a hospice can have on the symptoms of terminally ill patients, especially physical symptoms. For us it has highlighted areas of improvement especially psychological and spiritual care.
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