A/Prof Amanda Walker Bernadette King
|
|
- Olivia Fletcher
- 7 years ago
- Views:
Transcription
1 A/Prof Amanda Walker Bernadette King
2 Americans like to believe that death is an option. Woody Allen
3 PERCENTAGE WORLD MORTALITY RATES AD 1900 AD 2000 AD 2015 AD 2016 AD 2050 AD YEAR
4
5
6
7
8 To say, for example, that a man is made up of certain chemical elements is a satisfactory description only for those who intend to use him as a fertilizer. H. J. Muller : Science and Criticism (1943)
9 Death is a human experience, not just a negative patient care outcome
10
11 NSW data 2012 In NSW ~ 50% die in Acute Care Facilities 24,446 patients died in NSW Acute Care Facilities These patients experienced on average >3 admissions of >10 days each admission in the 12 months prior to death. 733,380 bed days occupied by those approaching death last year ~ 30% of these deaths are referred to Palliative Care Services Of these 70-80% are cancer-related
12 Further Background Learnings from Incident Information Management System Root Cause Analyses identify across the board that clinicians are failing to recognise when patients are at risk of dying developing appropriate treatment plans and communicating with patients and carers.
13 Further Background NSW data demonstrates that up to 30% of Rapid Response calls are for patients who are dying as a natural and unpreventable progression of their illness Documentation rarely demonstrates that patients and carers have been consulted about their preferred place of care
14 Dying in NSW* Greatest challenges related to staff discomfort initiating conversations with patients and carers; failure to recognise when patients are starting to die; and poor communication between staff and patients and carers. Lack of a standardised approach in the last days of life *results from 2012 QSA self assessment
15 Our responsibility, in medicine, is to deal with human beings as they are. People die only once. They have no experience to draw on. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come. Atul Gawande, 2014 Being Mortal: Medicine and What Matters in the End.
16 AW
17 Oscar the Cat New England Journal of Medicine 357(4):
18
19 The AMBER care bundle a way forward in providing safe and quality end of life care Assessment Management Best Practice Engagement of patients and carers for patients whose Recovery is uncertain
20 AMBER care bundle Developed at Guys and St Thomas Trust, UK Designed to prompt clinical teams to identify those at risk of dying, then have a discussion involving medical, nursing and allied health team members, in order to coordinate a plan for appropriate care, considering escalation / rapid response status, resuscitation plan and ceilings of treatment, and have appropriate conversations with patients and their carers, and then document them. Whilst recovery is uncertain, the patients may still be receiving active treatment (i.e. the AMBER care bundle is not a last days of life plan) Aim is too move the conversation forward both to the daytime, and to a point where the patient can participate
21 Where it fits
22 Expected benefits Better identification of and communication with patients whose recovery is uncertain Better team communication and clarity regarding treatment goals Better communication with carers and families regarding the medical plan and possible outcomes. Greater likelihood of patient dying in preferred place of death, and in lower acuity wards in acute care facilities Lower re-admission rates (70% decrease in UK facilities) 22
23 ACI / CEC LHD Connect Request from LHDs for practical tools to support best practice in End of Life Care by generalist practitioners ACI / CEC area of collaboration Work will be co-located with ACI Blueprint for Improvement Implementation in conjunction with ACI PC& EOL Network Focus on dying safely in acute facilities
24 Last Days of Life Toolkit 24
25 Last Days of Life Toolkit The Last Days of Life Toolkit includes: Tools to prompt & support communication - (both verbal and written) Comfort Observation & Symptom Assessment Chart for the dying patient (including pre & post care) Guidelines for standardised medications for the individual dying patient Transition to die at home package
26 Working Groups Clinical Lead Group A/Prof Joey Clayton Palliative Medicine Physician, HammondCare Palliative & Supportive Care Service, Greenwich and Royal North Shore Hospitals. Associate Professor of Palliative Care, Sydney Medical School, University of Sydney Dr Sarah Wenham Palliative Care Specialist, FWLHD Communication tools Guidelines for standardised approach to medications for the dying patient Ms Judith Jacques Nurse Practitioner, Palliative Care, Central Coast LHD A/Prof Amanda Walker Clinical Director End of Life program. Clinical Excellence Commission Transition to die at home Symptom assessment and management chart
27 Last Days of Life Toolkit Developed by a team of 71 specialist & generalist clinicians and consumers across NSW one face to face meeting in June then via teleconference +/- webex The toolkit is being developed for use by clinicians working in non-palliative care inpatient settings in NSW. Supporting resources and education strategies will be developed alongside each of the tools.
28 Comfort Observation & Symptom Assessment Chart 1. Initiation of the last days of life plan Signs & symptoms of dying Mandatory criteria Care planning 2. Comfort Observation & Symptom Assessment Chart (replaces SAGO chart) 3. Care after death
29 Symptom Assessment 29
30 Comfort Observations & Management 30
31 Medication Management Standardised prescribing guideline - pre-emptive subcutaneous medications for last days of life - in line with national medication chart & prescribing terminology Five symptom management flowcharts - pain, dyspnoea, agitated delirium, nausea/vomiting, secretions - Pharmacological & non-pharmacological management - review, escalation and consult recommendations Written for a generalist (JMO/GP/RN) audience Hospital in-patients, including smaller rural/remote facilities Transferrable into other care settings (community/racf)
32 Additional information overleaf: general prescribing information; opioid conversation chart; palliative care contact details
33 Communication Designed to provide information and support to the patient and their family/carers in the last days of life. To support, not replace conversations 1. Asking questions can help: an aid for people and their family/friends when approaching the last days of life 2. Family / carer information regarding care in the last days of life 3. What to consider when your family member or friend has expressed a wish to go home from hospital to die at home 4. When a person dies in hospital: what to expect and what to do next 5. Understanding grief and some suggestions that may help 6. Useful tips for clinicians for speaking to patients / families / carers about dying
34 Transition to die at home Aim to facilitate a safe, smooth and seamless transition of care from hospital to community for patients who can be supported to die at home. 4 tools developed 1. Accelerated transfer home for last days of life plan Plan that includes criteria for who is / can die at home; a record of care coordination and discharge planning 2. Ambulance cover letter explanation if patient dies during transport 3. Nursing handover care plan for community nurses and/or RACF staff 4. Information brochure What to do when someone dies at home immediate action
35 End of Life Program Recognising risk of dying Recognising Dying Death WELL UNCERTAIN RECOVERY LAST DAYS AFTER DEATH Advance Care Planning AMBER care bundle Last Days of Life Toolkit Care after Death - Bereavement Death Screening M&M/Clinical Review
36 In line with ACSQHC: National Consensus Statement: Essential Elements for Safe & High Quality End of Life Care National Standards (Version 2) UK: Review of Liverpool Care Pathway
37 Related NSW Health Policies Verification of Death and Medical Certificate of Cause of Death PD2105_040 Using Resuscitation Plans in End of Life Decisions PD2014_030 Care Coordination: planning from admission to transfer of care in NSW public hospitals PD2011_015 Medication Handling in NSW Public Health Facilities PD2013_043
38 NSW Coordinated approach MoH: PEACH packages Verification of death ROADMAP Advance Care Planning SHAPE conversations CEC: Death Review database ehealth: documentation of EOL decisions
39 Next Steps Consultation program web based feedback Pilot sites early 2016 Implementation late 2016 Tools available from the joint CEC / ACI portal Blueprint for improvement
40 ACI / CEC Collaboration ACI & CEC are working together on End of Life Developing joint single portal for all tools LDL toolkit and AMBER care bundle will be linked in with the CAREsearch Blueprint for EOL / Pall Care 40
41 SHAPE Conversations Supporting Health professionals in Advance Planning and End of life Conversations A MoH / CEC / HETI initiative Working group developed tools and curriculum for educational package Tiered training structure with a core training module which forms the basis upon which progressive training is built. Comprehensive experiential workshop for targeted health care professionals.
42 Meaningful death review Most units review preventable deaths 32% of clinical units do not monitor any performance measures relating to end of life care * Of the 68% that do, 78% monitor complaints and compliments Only 12% monitor the number of end of life patients with unrelieved physical symptoms * QSA
43 The chocolate box audit
44 Death Review Database An Inpatient Death Screening Tool has been developed, and a database built More than 14,000 Records reviewed this year! 82% (185) of facilities are using the database CHASM / SCIDUA notification added in May 2015 Next steps Community Health & Outpatient Services (incl. Mental Health) Reporting 44
45 End of Life Measures Did the patient have a MET call in the 24 hours prior to death? Date and time of last recorded observations taken prior to death Was there an advance care plan available? Was there a Not for CPR order documented? Were any symptoms of patient discomfort/distress documented in the 48 hours before death? Was the patient seen by the Palliative Care Team during this admission? Was the patient (with capacity) involved in the decision making process related to treatment plans and goals of care?
46 Preliminary outcomes 44% patients involved in Resuscitation Plan decision making Conversations often very late in admission 36% having MET calls in last 24 hours of life 43% had documented symptoms of discomfort or distress in 48 hours prior to death 37% seen by Palliative Care team 46
47 Morbidity & Mortality Review Guidelines Role of Death Review Data Clinician s Toolkit revision / update 47
48 Any questions?
49 Thank you A/Prof Amanda Walker Clinical Director Bernadette King Program Lead The Clinical Excellence Commission wish to acknowledge the support of Guy s and St. Thomas Charity Modernisation Initiative and support from the King s College and South London and Maudsley Charitable Funds The AMBER care bundle
Acute care toolkit 2
Acute care toolkit 2 High-quality acute care October 2011 Consultant physicians are at the forefront of delivering care to patients presenting to hospital with medical emergencies. Delivering this care
More informationQUALITY ACCOUNT 2015-16
QUALITY ACCOUNT 2015-16 CONTENTS Part 1 Chief Executive s statement on quality... 3 Vision, purpose, values and strategic aims... 4 Part 2 Priorities for improvement and statement of assurance... 5 2.1
More informationAgreed Job Description and Person Specification
Agreed Job Description and Person Specification Job Title: Line Manager: Professionally accountable to: Job Purpose Registered Nurse Lead Nurse Inpatient Unit Clinical Director Provide specialist palliative
More informationAccess to Palliative Care Bill [HL]
Access to Palliative Care Bill [HL] CONTENTS 1 Palliative care support 2 Duty to commission palliative care services 3 Education and training 4 Research 5 Care Quality Commission 6 Effect on other legal
More informationInquiry into palliative care services and home and community care services in Queensland. Submission to the Health and Community Services Committee
Inquiry into palliative care services and home and community care services in Queensland Submission to the Health and Community Services Committee August, 2012 1 Introduction The Queensland Nurses Union
More informationEmergency Department Short Stay Units
Policy Directive Emergency Department Short Stay Units Document Number PD2014_040 Publication date 13-Nov-2014 Functional Sub group Clinical/ Patient Services - Critical care Ministry of Health, NSW 73
More informationNational end of life qualifications and Six Steps Programme. Core unit mapping tool for learning providers
National end of life qualifications and Six Steps Programme Core unit mapping tool for learning providers National end of life qualifications and Six Steps Programme - Core unit mapping tool for learning
More informationSaint Catherine s Hospice Quality Accounts 2012/13
Saint Catherine s Hospice Quality Accounts 2012/13 Your Community, Your Hospice, Our Care Part 1- Statement from the Chief Executive On behalf of our Board of Trustees and the Senior Management Team, I
More informationThe End of Life Care Strategy promoting high quality care for all adults at the end of life. Prof Mike Richards July 2008
The End of Life Care Strategy promoting high quality care for all adults at the end of life Prof Mike Richards July 2008 The End of Life Care Strategy: Rationale (1) Around 500,000 people die in England
More informationAuthor s job title Interim End of Life Care Service Lead Directorate Medicine Directorate
Document Control Title End of Life Care (Adults) Policy Author Interim End of Life Care Service Lead Author s job title Interim End of Life Care Service Lead Directorate Medicine Directorate Department
More informationDeath Verification of Death and Medical Certificate of Cause of Death
Policy Directive Ministry of Health, NSW 73 Miller Street North Sydney NSW 2060 Locked Mail Bag 961 North Sydney NSW 2059 Telephone (02) 9391 9000 Fax (02) 9391 9101 http://www.health.nsw.gov.au/policies/
More informationSurvey to Doctors in England End of Life Care Report prepared for The National Audit Office
Survey to Doctors in England End of Life Care Report prepared for The National Audit Office 1 2008, medeconnect Table of Contents 1 SUMMARY OF FINDINGS... 3 2 INTRODUCTION... 5 3 RESEARCH OBJECTIVES AND
More informationAustralian Safety and Quality Framework for Health Care
Activities for the HEALTHCARE TEAM Australian Safety and Quality Framework for Health Care Putting the Framework into action: Getting started Contents Principle: Consumer centred Areas for action: 1.2
More informationTransfer of Care Guideline for Stroke Patients Stroke Reperfusion Workgroup
Transfer of Care Guideline for Stroke Patients Stroke Reperfusion Workgroup Contact: Mark Longworth, Stroke Network Manager, ACI, Mob 0417 680 482, Tel 02 8644 2188 Mark.Longworth@aci.health.nsw.gov.au
More informationService delivery interventions
Service delivery interventions S A S H A S H E P P E R D D E P A R T M E N T O F P U B L I C H E A L T H, U N I V E R S I T Y O F O X F O R D CO- C O O R D I N A T I N G E D I T O R C O C H R A N E E P
More informationAmbitions for Palliative and End of Life Care:
Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020 National Palliative and End of Life Care Partnership Association for Palliative Medicine; Association of Ambulance
More informationNational Clinical Programmes
National Clinical Programmes Section 3 Background information on the National Clinical Programmes Mission, Vision and Objectives July 2011 V0. 6_ 4 th July, 2011 1 National Clinical Programmes: Mission
More informationEvidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation
Health Informatics Unit Evidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation April 2011 Funded by: Acknowledgements This project was funded by the Academy of
More informationNorfolk Dementia Care Pathway. Zena Aldridge; Lesley-Ann Knox; Hilda Hayo
Norfolk Dementia Care Pathway Zena Aldridge; Lesley-Ann Knox; Hilda Hayo Need? Growing numbers of people with dementia. Majority live in their own homes. Family members providing care estimated to save
More informationThe Newcastle upon Tyne Hospitals NHS Foundation Trust. National Early Warning Score (NEWS) Policy
The Newcastle upon Tyne Hospitals NHS Foundation Trust National Early Warning Score (NEWS) Policy Version.: 1.0 Effective From: 3 December 2014 Expiry Date: 3 December 2016 Date Ratified: 1 September 2014
More informationEnd of Life Care Strategy
End of Life Care Strategy Quality Markers and measures for end of life care How people die remains in the memory of those who live on Dame Cicely Saunders Founder of the Modern Hospice Movement June 2009
More informationAustralian Safety and Quality Framework for Health Care
Activities for MANAGERS Australian Safety and Quality Framework for Health Care Putting the Framework into action: Getting started Contents Principle: Consumer centred Area for action: 1.1 Develop methods
More informationVQC Acute Pain Management Measurement Audit Tool Guidelines
Definition of Acute Pain The audit tools relate to acute pain only. Acute pain is defined as a normal physiologic and usually timelimited response to an adverse (noxious) chemical, thermal or mechanical
More informationPalliative Care Role Delineation Framework
Director-General Palliative Care Role Delineation Framework Document Number GL2007_022 Publication date 26-Nov-2007 Functional Sub group Clinical/ Patient Services - Medical Treatment Clinical/ Patient
More informationWorking with you to make Highland the healthy place to be
Highland NHS Board 2 June 2009 Item 5.3 POLICY FRAMEWORK FOR LONG TERM CONDITIONS/ANTICIPATORY CARE Report by Alexa Pilch, LTC Programme Manager, on behalf of Dr Ian Bashford, Medical Director and Elaine
More informationURN: Part B - Comfort Care Chart To be completed by attending Nursing and Care Staff A new chart is to be commenced daily
M F I The Brisbane South Palliative Care Collaborative (BSPCC) RAC EoLCP was developed as part of a project funded by the Department of Health and Ageing. The RAC EoLCP is adapted from the Liverpool Care
More informationRehabilitation Stroke Services Framework Summary 2013
Rehabilitation Stroke Services Framework Summary 2013 The Rehabilitation Stroke Services Framework is designed to enable the delivery and monitoring of best practice stroke care across Australia. Rehabilitation
More informationHospice Services Provided in a Long Term Care Facility. Companion Regulations for Hospices and Long Term Care Facilities
Hospice Services Provided in a Long Term Care Facility Companion Regulations for Hospices and Long Term Changes to the Medicare Hospice Conditions of Participation were published as a final rule on June
More informationNursing Home Type Patients and the National Acute Care Certificate
Policy Directive Ministry of Health, NSW 73 Miller Street North Sydney NSW 2060 Locked Mail Bag 961 North Sydney NSW 2059 Telephone (02) 9391 9000 Fax (02) 9391 9101 http://www.health.nsw.gov.au/policies/
More informationKeeping patients safe when they transfer between care providers getting the medicines right
PART 1 Keeping patients safe when they transfer between care providers getting the medicines right Good practice guidance for healthcare professions July 2011 Endorsed by: Foreword Taking a medicine is
More informationBarriers to Effective Pain Management. Dr. Huda Abu-Saad Huijer Director Hariri School of Nursing
Barriers to Effective Pain Management Dr. Huda Abu-Saad Huijer Director Hariri School of Nursing Introduction Unrelieved pain is a major, yet avoidable, public health problem. Despite more than 30 years
More informationA fresh start for the regulation of independent healthcare. Working together to change how we regulate independent healthcare
A fresh start for the regulation of independent healthcare Working together to change how we regulate independent healthcare The Care Quality Commission is the independent regulator of health and adult
More informationChapter 13 Continence
Chapter 13 Continence 13.1 Key audiences Primary care trusts: NHS trusts: commissioners of services for older people directors of public health directors of community nursing GPs. Nursing homes: medical
More informationWard Manager, Day Care Sister and Clinical Services
JOB DESCRIPTION Job Title : Line Manager: Responsible to: Manager Department : Staff Nurse (Day Care) Day Care Sister Ward Manager, Day Care Sister and Clinical Services Day Care Unit Probationary Period
More informationThe CCG Assurance Framework: 2014/15 Operational Guidance. Delivery Dashboard Technical Appendix DRAFT
The CCG Assurance Framework: 2014/15 Operational Guidance Delivery Dashboard Technical Appendix DRAFT 1 NHS England INFORMATION READER BOX Directorate Medical Operations Patients and Information Nursing
More informationGuidance for commissioners: service provision for Section 136 of the Mental Health Act 1983
Guidance for commissioners: service provision for Section 136 of the Mental Health Act 1983 Position Statement PS2/2013 April 2013 London Approved by the multi-agency Mental Health Act group chaired by
More informationDocument Details Title. Early Warning Score Protocol for Community Hospitals and Prisons to detect the Deteriorating Patient
Document Details Title Early warning Score Protocol for community Hospitals and Prisons to Detect the Deteriorating Patient Trust Ref No 1558-29748 Local Ref (optional) Main points the document This protocol
More informationProposed co-location of stroke services
Proposed co-location of stroke services Contents Contents... 2 Executive summary... 3 Introduction... 4 How stroke services are currently provided... 6 The case for change... 8 What is our proposed service
More informationStandard 5. Patient Identification and Procedure Matching. Safety and Quality Improvement Guide
Standard 5 Patient Identification and Procedure Matching Safety and Quality Improvement Guide 5 5 5October 5 2012 ISBN: Print: 978-1-921983-35-1 Electronic: 978-1-921983-36-8 Suggested citation: Australian
More informationNorth Shore Palliative Care Program
North Shore Palliative Care Program This booklet is intended for patients and families who are facing a life threatening illness. We hope that this booklet provides you with answers to some of your questions
More informationThe benefits of being in-house... An innovative model of care for palliative care nurse practitioners in Residential Aged Care
The benefits of being in-house... An innovative model of care for palliative care nurse practitioners in Residential Aged Care Peter Jenkin Nurse Practitioner What s my point? A palliative care nurse practitioner
More informationRoot Cause Analysis Investigation Tools. Concise RCA investigation report examples
Root Cause Analysis Investigation Tools Concise RCA investigation report examples www.npsa.nhs.uk/nrls Acute service example Mental health example Ambulance service example Primary care example Acute service
More informationSurvey of Nurses. End of life care
Survey of Nurses 28 End of life care HELPING THE NATION SPEND WISELY The National Audit Office scrutinises public spending on behalf of Parliament. The Comptroller and Auditor General, Tim Burr, is an
More informationSafety Alert Broadcast System Policy Directive
Policy Directive Ministry of Health, NSW 73 Miller Street North Sydney NSW 2060 Locked Mail Bag 961 North Sydney NSW 2059 Telephone (02) 9391 9000 Fax (02) 9391 9101 http://www.health.nsw.gov.au/policies/
More informationWITHDRAWAL OF LIFE SUPPORT BACKGROUND
WITHDRAWAL OF LIFE SUPPORT BACKGROUND The complainant s wife was admitted to a public hospital for an operation to secure access for peritoneal renal dialysis. At the time of the patient s admission she
More informationOncology Competency- Pain, Palliative Care, and Hospice Care
Pain, Palliative Care, and Hospice Care Palliative medicine relieves suffering and improves the quality of life for patients with advanced illness. The goal is achievement of the best quality of life for
More informationGuideline Health Service Directive
Guideline Health Service Directive Guideline QH-HSDGDL-025-3:2014 Effective Date: 17 January 2014 Review Date: 17 January 2016 Supersedes: qh-hsdptl-025-3:2012 Patient Access and Flow Health Service Directive
More informationAnnounced Follow-Up Inspection Dignity and Essential Care
Announced Follow-Up Inspection Dignity and Essential Care Cardiff and Vale University Health Board University Hospital of Wales Ward B7 Date of 29 th April 2014 1 HIW Follow-Up Inspection: Ward B7, University
More informationImproving Our Services for Older People in Cardiff and the Vale of Glamorgan. The Development of Clinical Gerontology Services
Improving Our Services for Older People in Cardiff and the Vale of Glamorgan The Development of Clinical Gerontology Services What s this document about? Cardiff and Vale University Health Board (UHB)
More informationSue Ryder s example of good practice in end of life care in domestic settings: joint and integrated working between health and social care.
Sue Ryder s example of good practice in end of life care in domestic settings: joint and integrated working between health and social care. About Sue Ryder Sue Ryder is a charitable provider of health
More informationTRIM: 93267. National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care in Acute Hospitals
TRIM: 93267 National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care in Acute Hospitals Consultation draft January 2014 Commonwealth of Australia 2014 This work is copyright.
More informationStaff Nurse Job Description
Staff Nurse Job Description Post Title: Staff Nurse - Wards Band : 5 Reports to: Team Leader Purpose of the post: To assess patient needs and to implement and evaluate programs of care to ensure the highest
More informationWhat is hospice care? Answering questions about hospice care
What is hospice care? Answering questions about hospice care Introduction If you, or someone close to you, have a life-limiting or terminal illness, you may have questions about the care you can get and
More informationSTATE OF NEVADA Department of Administration Division of Human Resource Management CLASS SPECIFICATION
STATE OF NEVADA Department of Administration Division of Human Resource Management CLASS SPECIFICATION TITLE GRADE EEO-4 CODE LICENSED PRACTICAL NURSE III 33* C 10.364 LICENSED PRACTICAL NURSE II 31* C
More informationDeath, Dying and Older People Death, dying and bereavement is a major part of the life experience of older people in Scotland:
Welcome to a special Improvement Network Bulletin edition focussing on palliative and end of life care. We would welcome your feedback on the Bulletins and suggestions for future topics contact us Please
More informationReproduced from: Royal College of Physicians, Royal College of Nursing.Ward rounds in medicine: principles of best practice.
2013 National Guideline on Ward Rounds Ministry of Health Quality Assurance Sectionn (QAS) Reproduced from: Royal College of Physicians, Royal College of Nursing.Ward rounds in medicine: principles of
More informationWhy does delirium develop?
What is delirium? Delirium is a name for acute confusion. The patient who is delirious is often experiencing a world that makes no sense to us but is very real to them. For instance they may: not know
More informationHamad Medical Corporation Ambulance & Mobile Healthcare Service
Hamad Medical Corporation Ambulance & Mobile Healthcare Service Mobile Healthcare embraces the vision of the HMC family We aim to deliver the safest, most effective and most compassionate care to each
More informationThe Economics of Improving End-of-life Care in Care Homes with Dementia Patients
The Economics of Improving End-of-life Care in Care Homes with Dementia Patients Dr Rob Gandy NHS Healthcare Consultant/ Associate with Liverpool John Moores University 3 nd Annual National Care Homes
More informationNMC Standards of Competence required by all Nurses to work in the UK
NMC Standards of Competence required by all Nurses to work in the UK NMC Standards of Competence Required by all Nurses to work in the UK The Nursing and Midwifery Council (NMC) is the nursing and midwifery
More informationRe: RANZCP comments on Australasian College of Emergency Medicine s Emergency Department Design Guidelines
8 May 2014 Ms Miranda Tassone Project Manager, Workforce Australasian College of Emergency Medicine 34 Jeffcott Street WEST MELBOURNE VIC 3000 By email to: miranda.tassone@acem.org.au Dear Ms Tassone Re:
More informationExecutive Summary. reputation as a place of choice for patients and other service users.
5 YEAR NURSING STRATEGY 2012-2017 1 Executive Summary The Walton Centre NHS Foundation Trust is the only specialist trust dedicated to providing neurosciences treatment care, and we pride ourselves on
More informationGuidance for Taking Responsibility: Accountable Clinicians and Informed Patients
June 2014 Guidance for Taking Responsibility: Accountable Clinicians and Informed Patients 01 Background Page 2 The Francis Report made a number of recommendations on the need for there to be a named clinician
More informationNational Early Warning Score. National Clinical Guideline No. 1
National Early Warning Score National Clinical Guideline No. 1 February 2013 The National Early Warning Score and COMPASS Education programme project is a work stream of the National Acute Medicine Programme,
More information1.2 Evidence-based practice 1.3 Environment 1.4 Multi-professional working 2. Enhance the patient/client experience 2.1 Person-centred care
JOB DESCRIPTION Title of Post: Diabetes Specialist Nurse Grade of Post: Band 7 Reports to: Accountable to: Location: Hours: Clinical Manager Assistant Director Medical Specialties Diabetes Acute Services
More informationPolicy Statement 16/2006. Acute and Multidisciplinary Working
RCN Policy Unit Policy Statement 16/2006 Acute and Multidisciplinary Working The Royal College of Nursing of the United Kingdom and the Royal College of Physicians (London) September 2006 Royal College
More informationFinding Meaning and Purpose in Palliative Care
Finding Meaning and Purpose in PALLIATIVE CARE WHAT IS IT? Jeffrey Rubins, MD Director, Palliative Medicine Hennepin Health Services deriv. from pallium, to cloak How do you pronounce palliative? medical
More informationOUTLINE Supportive care management of the advanced CKD patient
RENAL SUPPORTIVE CARE. NURSING EXPERIENCE AND PERSPECTIVES Renal Supportive Care Symposium 2013 Elizabeth Josland CNC OUTLINE Supportive care management of the advanced CKD patient Recognise patients who
More informationFamily Caregiver s Guide to Hospice and Palliative Care
Family Caregiver Guide Family Caregiver s Guide to Hospice and Palliative Care Even though you have been through transitions before, this one may be harder. If you have been a family caregiver for a while,
More informationConcerns, Complaints and Compliments
Concerns, Complaints and Compliments Exceptional healthcare, personally delivered Welcome to North Bristol NHS Trust North Bristol NHS Trust is the largest hospital trust in the South West of England,
More informationAcutely ill patients in hospital
Acutely ill patients in hospital Recognition of and response to acute illness in adults in hospital Issued: July 2007 NICE clinical guideline 50 guidance.nice.org.uk/cg50 NICE 2007 Contents Introduction...
More informationImproving end of life care in hospital
Improving end of life care in hospital 10 February 2014 Dr Martin McShane Director- Improving quality of life for people with LTCs Context 2 NHS Improving End of Life Care in hospitals What s the job?
More informationFramework for the Statewide Model for Palliative and End of Life Care Service Provision
Framework for the Statewide Model for Palliative and End of Life Care Service Provision ACKNOWLEDGEMENTS The Palliative Care Network Executive Committee: Dr Ghauri Aggarwal (Co-Chair) Dr Theresa Jacques
More informationInformation Governance. A Clinician s Guide to Record Standards Part 1: Why standardise the structure and content of medical records?
Information Governance A Clinician s Guide to Record Standards Part 1: Why standardise the structure and content of medical records? Contents Page 3 A guide for clinicians Pages 4 and 5 Why have standards
More informationSUPERSEDED BY OD0290/10
Aged Care Policy Directorate Enquiries to: Jeanette Plenty Tel: 9222 2162 Number: OD 0279/10 : 23/04/2010 Supersedes: OD0043/07 (29/03/2007) OP2067/06 (11/05/2006) OP1882/04 (02/12/2004) OP1576/02 (01/05/2002)
More informationWhat is Palliative Care
What is Palliative Care Maine Quality Counts Portland Regional Forum Isabella N. Stumpf, DO Division Director, Palliative Medicine, Maine Medical Center Medical Director, Palliative Care, MaineHealth Disclosure
More informationWandsworth Respiratory Clinical Reference Group Annual Progress Report 2014/15
Wandsworth Respiratory Clinical Reference Group Annual Progress Report 2014/15 April 2015 Dr Kieron Earney & Kate Symons Acknowledgements Dr Sarah Deedat Public Health Lead for Long Term Conditions 1 1.
More informationReport on announced visit to: The Rohallion Clinic, Murray Royal Hospital, Perth PH2 7BH
Mental Welfare Commission for Scotland Report on announced visit to: The Rohallion Clinic, Murray Royal Hospital, Perth PH2 7BH Date of visit: 10 March 2016 Where we visited The Rohallion Clinic opened
More informationQuality standard Published: 11 June 2015 nice.org.uk/guidance/qs89
Pressure ulcers Quality standard Published: 11 June 2015 nice.org.uk/guidance/qs89 NICE 2015. All rights reserved. Contents Introduction... 6 Why this quality standard is needed... 6 How this quality standard
More informationLambeth and Southwark Action on Malnutrition Project (LAMP) Dr Liz Weekes Project Lead Guy s & St Thomas NHS Foundation Trust
Lambeth and Southwark Action on Malnutrition Project (LAMP) Dr Liz Weekes Project Lead Guy s & St Thomas NHS Foundation Trust Page 0 What is the problem? Page 1 3 million (5 % population) at risk of malnutrition
More informationDay to day medical care of patients on the in-patient unit and day hospice. Advice and support to Trinity Clinical Nurse Specialists as needed
JOB DESCRIPTION: ACCOUNTABLE TO: RESPONSIBLE FOR: Speciality Doctor in Palliative Medicine Medical Director Day to day medical care of patients on the in-patient unit and day hospice. Advice and support
More informationThe Palliative Care Services of Tasmania
Information Booklet TASMANIAN PALLIATIVE CARE SERVICE Thanks to the palliative care community. The Tasmanian Palliative Care Service wishes to acknowledge the support provided by the members on the Palliative
More informationJOB DESCRIPTION Palliative Care Triage CNS
JOB DESCRIPTION Palliative Care Triage CNS Reporting to: Employment Status: Community Service Manager 0.9 FTE Date Prepared: January 2016 POSITION PURPOSE The Palliative Care Triage CNS (TCNS) provides
More informationEffective Approaches in Urgent and Emergency Care. Priorities within Acute Hospitals
Effective Approaches in Urgent and Emergency Care Paper 1 Priorities within Acute Hospitals When people are taken to hospital as an emergency, they want prompt, safe and effective treatment that alleviates
More informationHospice Isle of Man. Education Prospectus 2016. Leading the Way in Palliative Care
Hospice Isle of Man Education Prospectus 2016 Leading the Way in Palliative Care Introduction The need for palliative and end of life care is changing, with increasing demands and complexity. Therefore
More informationTime to Act Urgent Care and A&E: the patient perspective
Time to Act Urgent Care and A&E: the patient perspective May 2015 Executive Summary The NHS aims to put patients at the centre of everything that it does. Indeed, the NHS Constitution provides rights to
More informationTogether for Health Delivering End of Life Care. September 2013. Page 1 of 35
Together for Health Delivering End of Life Care September 2013 Page 1 of 35 HYWEL DDA HEALTH BOARD TOGETHER FOR HEALTH DELIVERING END OF LIFE CARE 1. BACKGROUND AND CONTEXT Together for Health End of Life
More informationStatewide strategy for end-of-life care 2015
Statewide strategy for end-of-life care 2015 May 2015 Acknowledgments This document was prepared by the Statewide Health Service Strategy and Planning Unit, Health Commissioning Queensland, Department
More informationJOB DESCRIPTION. 29,768 to 35,147 dependant on experience
JOB DESCRIPTION Job Title: Reporting to: Salary: Dementia Lead Nurse Operations Director 29,768 to 35,147 dependant on experience Spinal Point: 30 to 36 Contract: Hours of Work: Permanent Full time, 35
More informationJOB DESCRIPTION. Emergency Department Sister / Charge Nurse
JOB DESCRIPTION Title of Post: Emergency Nurse Practitioner Grade/ Band: Band 7 Directorate: Reports to: Accountable to: Initial Location: Hours: Medical Specialties Emergency Department Sister / Charge
More informationDevelopment of a Carer package for safe administration of subcutaneous medications across the Grampians Region
Development of a Carer package for safe administration of subcutaneous medications across the Grampians Region Background: The anticipatory prescribing of injectable medications such as opiates and benzodiazepines
More informationTransfer of Care from Mental Health Inpatient Services
Policy Directive Ministry of Health, NSW 73 Miller Street North Sydney NSW 2060 Locked Mail Bag 961 North Sydney NSW 2059 Telephone (02) 9391 9000 Fax (02) 9391 9101 http://www.health.nsw.gov.au/policies/
More informationHOW TO; Report a Serious Incident Requiring Investigation (SIRI) or a Significant Event (SEA) to the Surrey and Sussex Area Team
HOW TO; Report a Serious Incident Requiring Investigation (SIRI) or a Significant Event (SEA) to the Surrey and Sussex Area Team Quality & Safety Team, Nursing Directorate. HOW TO. Report a serious incident
More informationA Review of Palliative Care Competence Frameworks. Prepared for. The Palliative Care Competency Framework Development Project Steering Group
A Review of Palliative Care Competence Frameworks Prepared for The Palliative Care Competency Framework Development Project Steering Group A Review of Palliative Care Competence Frameworks, May 2012 Prepared
More information4. Proposed changes to Mental Health Nursing Pre-Registration Nursing
Developments in nurse education in England Summary BSMHFT employs 1319 registered nurses and 641 health care assistants 53% of the total workforce. BSMHFT works in partnership with Birmingham City University
More informationDo we or don t we? Ambulance crews and emergency calls at the end of life.
Do we or don t we? Ambulance crews and emergency calls at the end of life. Dan Munday Associate Clinical Professor/ Honorary Consultant in Palliative Medicine Development of End of Life Care for Paramedic
More informationExercise is Medicine Australia Education evaluation summary
Exercise is Medicine Australia Education evaluation summary Exercise is Medicine Australia (EIM Australia) seeks to support health care providers to become consistently effective in counselling and referring
More informationCare plans which are individualised and person centred
The Right Care: creating dementia friendly hospitals Care plans which are individualised and person centred Good practice for better care 1 Care plans which are individualised and person centred Section
More informationQuality Report. 2013-14 York Teaching Hospital NHS Foundation Trust
Quality Report 2013-14 York Teaching Hospital NHS Foundation Part 1 Overview Letter from the Chief Executive The Government s response to the issues raised in the Francis Inquiry into Mid Staffordshire
More informationOT service design for new emergency care - how we can support integrated practice
OT service design for new emergency care - how we can support integrated practice Barbara Kemp Clinical Lead for Occupational Therapy Northumbria Healthcare Foundation Trust #theotshow #theotshowselfie
More information