Education resource to support introduction of All Wales Care Decisions for the Last Days of Life All...

Education resource to support introduction of All Wales

Care Decisions for the Last Days of Life

All Wales palliative care education group

© All Wales Palliative Care Education Group 2015 1

Aims of the session

• To describe the new supporting tool ‘ Care Decisions for the last days of life’ to help deliver care in the last days of life

• Improve your confidence in understanding the new document


VIDEO


Learning outcomes

By the end of the session you should be able to:•Describe the new tool ‘ Care decisions for the last days of life ‘ to a colleague•Effectively explain the rationale for its use to patients and those important to them•Describe, to a more junior colleague, the 5 priorities of care that support effective care in the last days of life


The story so far…. • 1990’s in UK , a need to extend the gold standard of palliative care and ‘ hospice’

care into general hospitals and for non cancer patients resulted in the development of the Liverpool Care Pathway (LCP) in NHS England

• Wales – pathway developed into ‘Care priorities ‘ with annual quality and monitoring review

• 2012 first concerns in NHS England about use of LCP• 2013 major review of LCP and its withdrawal in England • 2013 Neuberger report – ‘ More care less pathway’• 2014 ‘ One chance to get it right’ NHS Leadership Alliance for care of the dying

person recommendations for England • 2014 in Wales – major review of the Integrated Priorities of care for the last days

of life – review of documentation, and survey of use in generalist setting• 2015 in Wales - launch of Care Decisions for the last days of life


Group discussion

• What information do families need to know when a patient is thought to be in the last days of their life ?

• Who is best placed to give this information ?• How does this process currently work in

practice?


Priorities as outlined in ‘One Chance to get it right’ NHS England


Key priorities of care in the last days of life

• Good Communication – good communication with patient and those important to them is essential.

• Good Symptom control – first priority for 85% of patients is to be pain free.

• Holistic care – need to consider all aspects of caring i.e. physical, psychological, social, and spiritual needs – for patient and those important to them.

• Individualised care – everyone has different priorities and concerns.

• Implicit in these, is the goal of involvement of patient and those important to them.



Page 1


Page 2


Page 3

NB, don’t forget the DNACPR form


Page 4


Symptom Assessment Sheet


Individual case review sheet


Symptom guidance is also provided

Care Decisions Community PRN chart


Subcutaneous syringe driver chart

Aims of the session

• To describe the new supporting tool ‘ Care Decisions for the last days of life’ to help deliver care in the last days of life

• Improve your confidence in understanding the new document

• Consider how the document could be utilized in your area


Learning outcomes

By the end of the session you should be able to:•Describe the new tool ‘ Care Decisions for the last days of life ‘ to a colleague•Effectively explain the rationale for its use to patients and those important to them•Describe, to a more junior colleague, the 5 priorities of care that support effective care in the last days of life


Summary

• Care Decisions tool is to help support decision making about effective and compassionate care in the last days of life

• It is not a substitute for clinical assessment , decision making and review by the team looking after the patient


How will your practice change or develop as a result of today?


Thank you

WWW Search for:• Dying matters• More care less pathway ( 2013)• One chance to get it right ( 2014)

www.pallcare.info

Your local palliative care team © All Wales Palliative Care Education Group

2015 22

http://www.pallcare.info/

Education resource to support introduction of All Wales Care Decisions for the Last Days of Life All...

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