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48 Using electronic comfort observations to support the care of the dying adult patient – what do staff users think?
  1. Nicola Kendal,
  2. Richard Cox,
  3. Susan Heatley and
  4. Ashique Ahamed
  1. Manchester Royal Infirmary, Manchester University Hospitals NHS Foundation Trust


Background The comfort observations is an electronic assessment method that mandates a minimum of 4 hourly checks using parameters that measure comfort (such as pain assessment, mouth care and respiratory effort) rather than physiological measurements, and trigger alerts for escalation of care. It was implemented by the Supportive and Palliative Care Team (SPCT) from October 2017 in the care of dying adult patients trust wide.

Methods A staff survey was conducted to gain views and user experiences of comfort observations. This paper survey was disseminated to different wards by SPCT members or ward ‘end of life care’ champions.

Results There were 42 respondents from different wards representing a range of healthcare professionals. Qualitatively the survey showed that staff felt empowered by the comfort observations to proactively monitor dying patients; ‘it enabled me to continue to monitor the patient without causing distress or discomfort’. They facilitated a structured approach and appropriate escalation. Staff felt patient care, and care of loved ones improved as a result; ‘Early recognition of pain. Reason for agitation and can be treated without delay. Although EWS is stopped, the continuous monitoring of patient is possible via comfort obs and alert system. Better end of life care experience for patient and relatives’. 100% of respondents felt the comfort obs were user friendly and would recommend them to other wards.

Conclusions Acute trusts are an important provider of end of life care. Comfort observations support staff to deliver proactive excellent end of life care through routine monitoring of domains of comfort and escalation of care when indicated. A robust training programme to support their use is being planned in addition to conducting a retrospective audit to assess if their use leads to improved frequency of assessing patient and carer needs.

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