Background The Health Needs Assessment for end of life care in the city has clearly identified the need for hospice care for those in the last few days/weeks of life. Part of the hospice’s five year strategy highlighted the intention to implement nurse-managed end of life care beds within the inpatient unit (IPU), offering end of life care to dying patients with generalist palliative care needs. There are currently four nurse-managed beds and one full-time and two part-time clinical nurse specialists.
Aims of the service The aim of the service is to provide nurse-led care for patients at the end of life who do not have specialist palliative care needs. The objectives are as follows:
To achieve the patients’ preferred place of care/death.
To improve the quality of end of life care received by the patient and their family.
To reduce hospital deaths.
To provide equitable service across the city.
More complex patients can have more medical time.
Method In order to evaluate the appropriateness of the patients admitted to the service a retrospective audit was undertaken. All patients admitted under the nurse-managed service were reviewed. Over a six month period 45 patients were referred to the hospice by the community nursing team or the teaching hospitals.
Results The audit revealed 7 out of the 45 patients were referred back to the medical team as they did not fulfil the nurse-managed bed criteria. Of the 7 patients referred back to the medical team 3 patients went home or to a care home and 4 patients became end of life care.
Conclusion Overall the audit revealed that the majority of the patients referred were appropriate to be managed by the nurse-led service. The patients referred continue to increase as the primary and secondary care services become more aware of the access to the nurse-managed beds as it is seen as a valuable resource. We are currently awaiting quality approval for our patient satisfaction survey. Once we have this we will be sending it out to all patients who consent to receiving it.
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