Title:
Implementation of an End-of-Life Care Plan in the Acute Care Setting.
Background:
Evidence demonstrates that a majority of Australians die in the Acute Care Setting, despite this not being their preference. Delivering optimal care at End of life for patients and their families can be complex due to multifactorial reasons.
In Tasmania, there were 4,500 deaths in 2020, 870 of these occurred at the Royal Hobart Hospital.
Aims:
This presentation will discuss the development of The State-wide End of Life Care Plan developed in relation to the NSQHS, Comprehensive Care Standard 5.
This multidisciplinary care plan aims to ensure, a comprehensive assessment is completed, including patient and family wishes, ensure unnecessary interventions are ceased, improve symptom management, provide medication guidelines for prescribing for End-of-Life Care, and a Track and Trigger chart specific to monitoring both physical and psychological symptoms.
Procedure:
The implementation of this Plan is currently being trialled across the State in the Acute and Sub Acute Settings. A comprehensive education plan is being delivered for Nursing, Allied Health and Medicine, pertaining to the plan as well as broader End-of-Life education needs such as identifying dying, communication training in ‘Breaking bad news’, empathy and discussing Goals of Care.
Outcomes:
Implementation at The Royal Hobart Hospital, Launceston General Hospital and 6 Regional Hospitals.
Implications for Practice:
The End-of-Life Care Plan provides prompts for conversations, assessment, and symptom relief. This plan is a tool to improve end of life care in the Acute Care setting by empowering both nursing and medicine to embrace the clinical skills they have in caring for the dying and support development to improve the experience for clinicians, the patient and their families.
Conclusions:
The implementation of this care plan is in its infancy with further scope to include adaptation for Community Nursing and Residential Aged Care.
Implementing and embedding the completion of this document into daily nursing practice has been challenging and requires further examination within this project.
Further exploration pertaining to patients and families experiences and reviewing outcomes of improved End-of -Life care for patients on the care plan will be completed in 2022.