Audit of the Care of the Dying in a Network of Hospitals and Institutions in Queensland

Hardy, J R, Haberecht, J, Maresco-Pennisi, Diane, & Yates, Patsy (2007) Audit of the Care of the Dying in a Network of Hospitals and Institutions in Queensland. Internal Medicine Journal, 37(5), pp. 315-319.

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Background: Most Australians die in institutions and there is evidence to suggest that the care of these patients is not always optimal. Care pathways for the dying have been designed to transfer benchmarked hospice care to other settings (e.g. acute hospitals and residential age-care facilities) by defining goals of best care, providing guidelines to provide that care and documenting outcome. Method: A retrospective audit was undertaken across a network of health-care institutions in Queensland. The 18 goals considered essential for the care of the dying within the Liverpool Care Pathway were taken as a benchmark. Documentation of achievement of each of these goals was sought. Results: The notes of 160 patients who had died in eight institutions (four hospitals, three hospices, one nursing home) were reviewed. Several areas for improvement were identified, particularly in those goals relating to communication, resuscitation orders and care after death. Few units documented the provision of written information to families. Most patients were prescribed medications in anticipation of pain and agitation but less were prescribed drugs for other common symptoms in the dying. Most of the goals were achieved in a higher percentage of cases in hospice units. Marked differences in practice were noted between different institutions. Conclusion: The audit identified several aspects in the care of the terminally ill that could be improved. End-stage pathways may provide a model for improving the care of patients dying in hospitals and institutions in Australia.

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23 citations in Scopus
22 citations in Web of Science®
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ID Code: 33675
Item Type: Journal Article
Refereed: Yes
Keywords: audit, care of the dying, care pathways
DOI: 10.1111/j.1445-5994.2007.01314.x
ISSN: 1444-0903
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Nursing
Deposited On: 02 Aug 2010 04:37
Last Modified: 29 Feb 2012 13:38

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