Decisions relating to CPR
|
|
- Natalie Bryan
- 8 years ago
- Views:
Transcription
1 Decisions relating to CPR A joint statement by the BMA, RC(UK) & RCN David Pitcher Consultant Cardiologist, University Hospital Birmingham Chairman, Resuscitation Council (UK)
2 Conflicts of interest Contributor on behalf of RC(UK) to Decisions relating to cardiopulmonary resuscitation Member of expert group for NCEPOD study on cardiac arrest No financial conflicts of interest
3 A journey CPR decisions How did we get here? Where are we? Where are we going?
4 How did we get here?
5 CORONARY CARE UNITS Julian DG Treatment of cardiac arrest in acute myocardial ischaemia and infarction Lancet 1961;ii: Killip T, Kimball JT Treatment of myocardial infarction in a coronary care unit: a two-year experience with 250 patients Am J Cardiol 1967;20:
6 Younger, fitter patients admitted to CCU Presumption for CPR
7 ...but... Natural history of AMI changed: fewer STEMI, fewer VF arrests Many more patients admitted to CCU with multiple medical problems and limited life expectancy
8 ...and... CPR still used in other settings Huge increase in admissions Older, sicker patients Outcome from CPR poor
9 CPR not appropriate for all Decisions about CPR.DNR.No code.dnar.dnacpr
10 The year 2000 The Human Rights Act 1998 became law and
11 April 2000 Cancer patient's fury at doctor who 'wrote her off on hospital's death ward' The Guardian Thursday 13 April 2000 Secret 'not for resuscitation' code on pensioner's notes By Jeremy Laurance, Health Editor Thursday 13 April 2000
12 March 2001
13 The year 2007 Problems reported with Joint Statement 2001
14 Decisions relating to cardiopulmonary resuscitation 2001 decisions about whether the likely benefits from successful CPR outweigh burdens should be discussed with competent patients. where patients are at foreseeable risk of cardiac arrest, or have a terminal illness, there should be a sensitive exploration of their wishes regarding resuscitation
15 Misinterpreted by some healthcare professionals as indicating: compulsion to discuss CPR with all patients requirement for consent for DNACPR Tendency to discourage CPR decisions
16 also in 2007 The Mental Capacity Act 2005 became law
17
18 Decisions about CPR must be made on the basis of an individual assessment of each patient s case
19 Advance care planning, including making decisions about CPR, is an important part of good clinical care for those at risk of cardiorespiratory arrest
20 Communication and the provision of information are essential parts of good quality care
21 It is not necessary to initiate discussion about CPR with a patient if there is no reason to believe that the patient is likely to suffer a cardiorespiratory arrest
22 Where no explicit decision has been made in advance there should be an initial presumption in favour of CPR
23 If CPR would not re-start the heart and breathing it should not be attempted
24 Where the expected benefit of CPR may be outweighed by the burdens, the patient s informed views are of paramount importance
25 If the patient lacks capacity those close to the patient should be involved in discussions to explore the patient s wishes, feelings, beliefs and values
26 If a patient with capacity refuses CPR, or a patient lacking capacity has a valid and applicable advance decision refusing CPR, this should be respected
27 A DNAR decision does not override clinical judgement in the unlikely event of a reversible cause of the patient s respiratory or cardiac arrest that does not match the circumstances envisaged
28 DNAR decisions apply only to CPR and not to any other aspects of treatment
29 Lots of take-home messages. What did the media take home?
30
31
32
33 Since 2007 Joint Statement well-received Most comprehensive guidance available No major negative feedback But is it working?
34 Are you prepared to be shocked? Audit of Resuscitation Decisions in a Coronary Care Unit 2007
35 Resuscitation status recorded in 9/114 (8%) Discussion possible/appropriate in 104/114 (91%) Discussion with families occurred in only 3 cases (Families not usually visiting during ward rounds)
36 1 Individual assessment? X 2 Advance care planning X 3 Communication X 4 No need for discussion if risk low N/A 5 Default position OVERUSED 6 No CPR if it won t work? 7 Patient s views paramount X 8 MCA: involve family etc X 9 Patient s refusal respected N/A 10 Use of clinical judgement N/A 11 DNACPR applies only to CPR N/A
37 Where are we now?
38
39 Inadequacies identified: Hospital organisation Initial assessment Record-keeping Physiological observations not prescribed Deterioration not recognised/acted upon Care not escalated Location of patient Consideration of CPR decision Resuscitation attempt Post-arrest care
40 1 Individual assessment? X 2 Advance care planning X 3 Communication X 4 No need for discussion if risk low N/A 5 Default position OVERUSED 6 No CPR if it won t work X 7 Patient s views paramount X 8 MCA: involve family etc X 9 Patient s refusal respected? 10 Use of clinical judgement N/A 11 DNACPR applies only to CPR N/A
41 PRINCIPLE RECOMMENDATIONS Explicit CPR decision for all acute admissions More consultant involvement Escalation for deterioration Better understanding of CPR decisions Plan for airway management during CPR Audit of all CPR attempts
42 Where are we going?
43 Decisions relating to CPR 2013
44 Do not resuscitate order 'twice added without consent' A bereaved husband has begun a legal action over "do not resuscitate" orders placed on his wife's medical notes. 6:20PM GMT 05 Nov 2012 Hubby sues on let wife die orders Resuscitate row By MATT WILKINSON Published: 06th November 2012
45 13 September 2012 Down's syndrome patient challenges resuscitation order By Jane Dreaper Health correspondent, BBC News A man with Down's syndrome is suing an NHS trust over a hospital's decision to issue a do-not-resuscitate order giving his disability as one of the reasons. Sunday 4 November GMT Mother of man with cerebral palsy sues hospital over son's DNR order Elaine Winspear seeks to challenge doctor's 'unilateral' order not to resuscitate son Carl, who died at Sunderland Royal hospital James Meikle The Guardian
46 NHS constitution reform to include new end-of-life care commitments Measures may include suing health trusts that fail to fully discuss issues and striking off doctors who ignore patients' wishes Press Association The Guardian, Sunday 4 November GMT
47 Decisions relating to CPR 2013 Guidance will reflect current: law professional codes of practice ethics and.i hope
48
49 Decisions relating to CPR 2013 Balancing needs of patients and of clinicians across full spectrum of settings
50 Decisions relating to CPR 2013 Guidance is only as effective as the people who use it the way that they use it.
51 12 steps to good CPR decisions
52 12 steps to good CPR decisions Communication, communication, communication
53 12 steps to good CPR decisions Communication, communication, communication Communication, communication, communication
54 12 steps to good CPR decisions Communication, communication, communication Communication, communication, communication Education, education, education
55 12 steps to good CPR decisions Communication, communication, communication Communication, communication, communication Education, education, education Education, education, education
56
Decisions relating to cardiopulmonary resuscitation
October 2014 3rd edition Decisions relating to cardiopulmonary resuscitation Guidance from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing (previously known
More informationOhio s Do-Not-Resuscitate Law
Ohio s Do-Not-Resuscitate Law Copied from Choices: Living Well at the End of Life developed in collaboration with the Ohio Hospice and Palliative Care Organization, the Ohio State Medical Association,
More informationDeciding Right Professional FAQs (v11)
Deciding Right Professional FAQs (v11) DECIDING RIGHT What is Deciding Right? Deciding right enables professionals and organisations to be compliant with key legal and clinical frameworks. It does this
More informationPLANNING FOR YOUR MENTAL AND PHYSICAL HEALTH CARE
PLANNING FOR YOUR MENTAL AND PHYSICAL HEALTH CARE AND TREATMENT THE ADVANCE DIRECTIVE PROVIDER TRAINING PROJECT New York Association of Psychiatric Rehabilitation Services One Columbia Place Albany, NY
More informationPaediatric Early Warning Score Clinical Guideline
Paediatric Early Warning Score Clinical Guideline All healthcare professionals must exercise their own professional judgement when using guidelines. However any decision to vary from the guideline should
More informationPower of Attorney for Health Care For
Power of Attorney for Health Care For Name: Date of Birth: Address: Telephone: This document is on file at Copies of this document have been given to my health care agent(s) and: 1. 2. 3. 4. 5. Courtesy
More informationEnd of life treatment and care: Good practice in decision-making. A draft for consultation
End of life treatment and care: Good practice in decision-making A draft for consultation 1 End of life treatment and care: Good practice in decision-making Paragraphs About the guidance 1-5 How the guidance
More informationUnified Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Adult Policy
Unified Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Adult Policy Developed in conjunction with: North West Ambulance Service NHS Trust, Cheshire and Merseyside Strategic Clinical Network, Greater
More informationGuidance for doctors. Treatment and care towards the end of life: good practice in decision making
Guidance for doctors Treatment and care towards the end of life: good practice in decision making The duties of a doctor registered with the Patients must be able to trust doctors with their lives and
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 informationDeciding About. Health Care A GUIDE FOR PATIENTS AND FAMILIES. New York State Department of Health
Deciding About Health Care A GUIDE FOR PATIENTS AND FAMILIES New York State Department of Health 1 A GUIDE FOR PATIENTS AND FAMILIES Introduction Who should read this guide? This guide is for New York
More informationA GUIDE TO ADVANCE CARE PLANNING
A GUIDE TO ADVANCE CARE PLANNING Advance Care Planning is a process that ensures your family and treating healthcare team understand what is important to you and how you want to be treated if you become
More informationUtah Advance Directive Form & Instructions
Utah Advance Directive Form & Instructions 2009 Edition published by Utah Medical Association 310 E. 4500 South, Suite 500 Salt Lake City, UT 84107 Instructions for Completing the Advance Health Care Directive
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 informationCardio-Pulmonary Resuscitation (CPR): A Decision Aid For. KGH Patients And Their Families
Cardio-Pulmonary Resuscitation (CPR): A Decision Aid For KGH Patients And Their Families The goal of this pamphlet is to provide information about cardiopulmonary resuscitation (CPR) so you can be adequately
More informationHealth Care Proxy Appointing Your Health Care Agent in New York State
Health Care Proxy Appointing Your Health Care Agent in New York State The New York Health Care Proxy Law allows you to appoint someone you trust for example, a family member or close friend to make health
More informationNEW YORK Advance Directive Planning for Important Healthcare Decisions
NEW YORK Advance Directive Planning for Important Healthcare Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
More informationTALKING ABOUT YOUR HEALTH CARE CHOICES: ADVANCE DIRECTIVE INFORMATION, FORM AND GUIDELINES
TALKING ABOUT YOUR HEALTH CARE CHOICES: ADVANCE DIRECTIVE INFORMATION, FORM AND GUIDELINES Adults have a right to accept or refuse medical care. You have the legal right to make an advance directive. In
More informationALLOW NATURAL DEATH/WITHHOLDING AND/OR WITHDRAWING L I F E - S U S T A I N I N G T R E A T M E N T / NON-BENEFICIAL CARE AND RESUSCITATION POLICY
PURPOSE SUPPORTIVE DATA To specify the parameters within which decisions regarding the withholding and/or withdrawing of life-sustaining treatment/non beneficial care and/or no initiation of cardiopulmonary
More informationRedefining the NSTEACS pathway in London
Redefining the NSTEACS pathway in London Sotiris Antoniou Consultant Pharmacist, Cardiovascular Medicine, Barts and The London NHS Trust and Project Lead, North East London Cardiovascular and Stroke Network
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 informationMy Voice. Advance Care Plan
My Voice Advance Care Plan A message from the Prince Edward Family Health Team... Since its beginning in 2006 the Prince Edward Family Health Team (PEFHT) has been striving to provide comprehensive, accessible
More informationChild and Young Person s Advance Care Plan Policy
Child and Young Person s Advance Care Plan Policy www.southcentral.nhs.uk NHS South Central. March 2010. CS18784. Designed by NHS Creative - www.nhscreative.org Child & Young Person s Advance Care Plan
More informationYour Future, Your Health Power of Attorney for Health Care
CFS 2032-2 12/2010 State of Illinois Department of Children and Family Services Your Future, Your Health Power of Attorney for Health Care As you transition toward independence, it is important for you
More informationPatient and Family Guide to Advance Directives. Information on Health Care Proxies and Living Wills 50611701 (8/04)
Patient and Family Guide to Advance Directives Information on Health Care Proxies and Living Wills Member of the HealthCare System 50611701 (8/04) Introduction Advances in modern medical care have not
More informationSeeking consent: working with older people
Seeking consent: working with older people Contents Page Introduction 1 Seeking consent: people with capacity 3 When adults lack capacity 9 Research 13 Withdrawing and withholding life-prolonging treatment
More informationDecision-making for the End of Life
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO POLICY STATEMENT #1-06 Decision-making for the End of Life APPROVED BY COUNCIL: REVIEWED AND UPDATED: PUBLICATION DATE: TO BE REVIEWED BY: KEY WORDS: RELATED
More informationGlossary of Terms and Acronyms
Glossary of Terms and Acronyms Term/Abbreviation Accident and Emergency (A&E) Service Advanced Medical Priority Dispatch System (AMPDS) Ambulance Quality Indicators (AQIs) Ambulance Service Cardiovascular
More informationWhat Are Advance Medical Directives?
What Are Advance Medical Directives? UAMS would like you to know that there are ways to let others know what decisions you would want to make about your medical treatments, even when you are unable to
More informationUTAH Advance Directive Planning for Important Health Care Decisions
UTAH Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of the
More informationAdvance Care Planning
Queensland Health Advance Care Planning Think now. Plan sooner. Peace of mind later. CONTENTS Planning for your future care 4 What is advance care planning? 6 Why should I plan ahead? 8 Who can undertake
More informationThe La Crosse Region Power of Attorney for Healthcare Document and The Instructions for Completing this Document
Overview The La Crosse Region Power of Attorney for Healthcare Document and The Instructions for Completing this Document The attached power of attorney for healthcare form is a legal document, developed
More informationDegree of Intervention
Inglewood Care Centre Degree of Intervention Handbook for Residents and Families Index Introduction..................................................... 2 Beliefs, Values, and Wishes.........................................
More informationPolicy: B4 Basic Life Support Policy
Policy: B4 Basic Life Support Policy Version: B4/04 Ratified by: Trust Management Team Date ratified: 15 th April 2015 Name and Title of Author: Director of Primary Care Accountable Director Medical Director
More informationNEW YORK Advance Directive Planning for Important Healthcare Decisions
NEW YORK Advance Directive Planning for Important Healthcare Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
More informationRuchika D. Husa, MD, MS Assistant t Professor of Medicine in the Division of Cardiology The Ohio State University Wexner Medical Center
Modified Early Warning Score (MEWS) Ruchika D. Husa, MD, MS Assistant t Professor of Medicine i in the Division of Cardiology The Ohio State University Wexner Medical Center MEWS Simple physiological scoring
More informationIntro Who should read this document 2 Key Messages 2 Background 2
Classification: Policy Lead Author: Nathan Griffiths, Consultant Nurse Paediatric Emergency Medicine Additional author(s): N/A Authors Division: Salford Healthcare Unique ID: DDCPan04(14) Issue number:
More informationOne. Choosing the Care You Want: ADVANCE DIRECTIVES
One Choosing the Care You Want: ADVANCE DIRECTIVES At Carolinas HealthCare System, we believe your care should line up with your health goals at each stage of your life. In good health and in sickness,
More informationEarly Warning Scores (EWS) Clinical Sessions 2011 By Bhavin Doshi
Early Warning Scores (EWS) Clinical Sessions 2011 By Bhavin Doshi What is EWS? After qualifying, junior doctors are expected to distinguish between the moderately sick patients who can be managed in the
More informationMAINE Advance Directive Planning for Important Health Care Decisions
MAINE Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Organization
More informationADVANCE PERSONAL PLAN
ADVANCE PERSONAL PLAN Plan for a future where your health, financial and lifestyle wishes and opinions are heard and respected. www.advancepersonalplanning.nt.gov.au Advance Personal Plan This form will
More informationYOUR RIGHT TO MAKE HEALTH CARE DECISIONS
This pamphlet informs you about your right to make health care decisions, including the right to accept or refuse medical treatment. It explains the following advance directives and related subjects: YOUR
More informationPut it in Writing. Questions and Answers on Advance QDirectives. www.aha.org July 1998, Revised December 2012, Item No. 166909
Put it in Writing uestions and nswers on dvance Directives www.aha.org July 1998, Revised December 2012, Item No. 166909 ii Many people today are worried about the medical care they would receive if they
More informationGP SERVICES COMMITTEE Palliative Care INCENTIVES. Revised 2015. Society of General Practitioners
GP SERVICES COMMITTEE Palliative Care INCENTIVES Revised 2015 Society of General Practitioners GPSC Palliative Care Planning and Management Fees The following incentive payments are available to B.C. s
More informationThe Implementation of a Paediatric Early Warning Tool for use within the Emergency Department and on Acute Paediatric wards
Stockport NHS Foundation Trust NHS Every patient The Implementation of a Paediatric Early Warning Tool for use within the Emergency Department and on Acute Paediatric wards SN Nicola Adshead SN Raynie
More informationEnd-of-Life Decisions
End-of-Life Decisions This booklet addresses issues that matter to us all, because we will all face the end of life. Advance directives living wills and healthcare powers of attorney are valuable tools
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 informationFuture National Clinical Priorities for Ambulance Services in England
Background Future National Clinical Priorities for Ambulance Services in England National Ambulance Service Medical Directors (NASMeD) April 2014 Ambulance services have delivered significant improvements
More informationPART 1 ALASKA DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS (1) DESIGNATION OF AGENT.
Page1 PART 1 ALASKA DURABLE POWER OF ATTORNEY FOR HEALTH CARE DECISIONS (1) DESIGNATION OF AGENT. I designate the following individual as my agent to make health care decisions for me: Name Phone: Home
More informationPriorities of Care for the Dying Person Duties and Responsibilities of Health and Care Staff with prompts for practice
Priorities of Care for the Dying Person Duties and Responsibilities of Health and Care Staff with prompts for practice Published June 2014 by the Leadership Alliance for the Care of Dying People 1 About
More informationDocument Ratification Group Approved on 25 th June 2009 Trust Executive Board Date July 2009 Next Review Date June 2011
Verification of Adult Death by Registered Nurses Document Type: Policy Register Number: 07016 Status Public Developed in response to: Contributes to CQC Core Standard Hospital at night and Reduction in
More informationOKLAHOMA Advance Directive Planning for Important Health Care Decisions
OKLAHOMA Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
More informationUTAH Advance Directive Planning for Important Health Care Decisions
UTAH Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
More informationPOWERS OF ATTORNEY FOR PERSONAL CARE
LEGAL UPDATE Carters Professional Corporation / Société professionnelle Carters Barristers, Solicitors & Trade-mark Agents / Avocats et agents de marques de commerce JANUARY 2005 Editor: Terrance S. Carter
More informationINFORMATION ON DO-NOT-RESUSCITATE (DNR) REQUESTS IN EMERGENCY MEDICAL SERVICES
INFORMATION ON DO-NOT-RESUSCITATE (DNR) REQUESTS IN EMERGENCY MEDICAL SERVICES This summary provides information about the types of Do-Not-Resuscitate (DNR) requests that will be honored in the field by
More informationMISSISSIPPI Advance Directive Planning for Important Healthcare Decisions
MISSISSIPPI Advance Directive Planning for Important Healthcare Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National
More informationTreatment Escalation Plan & Resuscitation Decision Record. (in relation to the adult patient over 18 years) V4.0
Treatment Escalation Plan & Resuscitation Decision Record (in relation to the adult patient over 18 years) V4.0 1 st June 2015 Table of Contents 1. Introduction... 3 2. Purpose of this Policy/Procedure...
More informationADVANCE DIRECTIVE. Your Right to Make Health Care Decisions
ADVANCE DIRECTIVE Your Right to Make Health Care Decisions 1 Saint Peter s University Hospital provides you with this booklet which explains your rights to decide about your health care under New Jersey
More information2 North Meridian Street Indianapolis, Indiana 46204 March 1999 Revised May 2004 Revised July 1, 2013 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE
2 North Meridian Street Indianapolis, Indiana 46204 March 1999 Revised May 2004 Revised July 1, 2013 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE The purpose of this brochure is to inform you of ways that you
More informationLIST OF SUBSTITUTE DECISION MAKERS WHO MAY GIVE OR REFUSE CONSENT IN RESPECT TO HEALTH CARE MATTERS IF A PERSON IS NOT MENTALLY CAPABLE
LIST OF SUBSTITUTE DECISION MAKERS WHO MAY GIVE OR REFUSE CONSENT IN RESPECT TO HEALTH CARE MATTERS IF A PERSON IS NOT MENTALLY CAPABLE Introduction By: Judith A. Wahl B.A., LL.B. Advocacy Centre for the
More informationMedical Innovation Bill
Medical Innovation Bill Response to the Department of Health Consultation, April 2014 Kingsley Napley LLP are a firm of solicitors. We have a team that specialises in clinical negligence, acting exclusively
More informationA National Early Warning Score for the NHS
A National Early Warning Score for the NHS Professor Gary B Smith FRCA FRCP Centre of Postgraduate Medical Research & Education, School of Health and Social Care, Bournemouth University - from local data
More informationILLINOIS Advance Directive Planning for Important Health Care Decisions
ILLINOIS Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
More informationTHE ROYAL CORNWALL HOSPITALS NHS TRUST RESPONSE TO INFORMATION REQUEST. Date Request Received: 20 October 2014 FOI Ref: 567
FREEDOM OF INFORMATION ACT 2000 THE ROYAL CORNWALL HOSPITALS NHS TRUST RESPONSE TO INFORMATION REQUEST Date Request Received: 20 October 2014 FOI Ref: 567 Requested Information I would like to know whether
More informationData capture form for telephone application
PERSONAL MENU PLAN Data capture form for telephone application Information for advisers how to use our telephone application service To apply for a Royal London Personal Menu Plan, simply go to adviser.royallondon.com
More informationImproving Emergency Care in England
Improving Emergency Care in England REPORT BY THE COMPTROLLER AND AUDITOR GENERAL HC 1075 Session 2003-2004: 13 October 2004 LONDON: The Stationery Office 11.25 Ordered by the House of Commons to be printed
More informationRespecting Patient Choices
Respecting Patient Choices If we know your choices for future health care we are then able to respect them Advance Care Planning Information Booklet Take time to consider... Imagine the following: You
More informationAdvance Health Care Planning: Making Your Wishes Known
Page 1 of 26 Advance Health Care Planning: Making Your Wishes Known Page 2 of 26 What s Inside Why Health Care Planning Is Important... 2 What You Can Do... 4 Work through the advance health care planning
More informationleading edge Introduction
the voice of NHS leadership leading edge 3rd in a series of papers on community health and care NOVEMBER 2005 ISSUE 12 Improving end-of-life care Key points Some 56 per cent of people would prefer to die
More informationAN ETHICAL FRAMEWORK FOR CONTROLLED DONATION AFTER CIRCULATORY DEATH
AN ETHICAL FRAMEWORK FOR CONTROLLED DONATION AFTER CIRCULATORY DEATH UK DONATION ETHICS COMMITTEE DECEMBER 2011 Copyright Academy of Medical Royal Colleges 2011 2 AN ETHICAL FRAMEWORK FOR CONTROLLED DONATION
More informationMinnesota Health Care Directive
Minnesota Health Care Directive A Health Care Directive is a written document that informs others of your wishes about your health care. It allows you to name a person ( agent ) to decide for you if you
More informationADVANCE DIRECTIVE. A LIVING WILL A Directive To Withhold Or To Provide Treatment. A Durable Power Of Attorney FOR HEALTH CARE
ADVANCE DIRECTIVE A LIVING WILL A Directive To Withhold Or To Provide Treatment and A Durable Power Of Attorney FOR HEALTH CARE Name Date of Birth Form # 8-0553 (7-07) LIVING WILL AND DURABLE POWER OF
More informationState of Ohio Advance Directives: Health Care Power of Attorney Living Will Declaration
State of Ohio Advance Directives: Health Care Power of Attorney Living Will Declaration I have completed a Health Care Power of Attorney: Yes No. I have added special notes to my Health Care Power of Attorney:
More informationHealth Care Directive
PATIENT EDUCATION Health Care Directive Honoring Choices My Health Care Directive I created this document with much thought to give my treatment choices and personal preferences if I cannot communicate
More informationNational Early Warning Score
National Early Warning Score National Clinical Guideline No. 1 Summary February 2013 National Clinical Effectiveness Committee (NCEC) The National Clinical Effectiveness Committee (NCEC) was established
More informationThis is consistent with our guidance in Good medical practice, which says:
26 August 2014 Bill Rogers Competition and Markets Authority Dear Bill Rogers, Draft Order Thank you for meeting my colleague Catherine Thomas to discuss your Order. This letter is our formal response.
More informationThe Right to Decide. to the health care professionals who provide the care? All persons have the fundamental right to
The Right to Decide We have the right to make health care decisions, but how do we communicate them clearly to the health care professionals who provide the care? All persons have the fundamental right
More informationINDIANA Advance Directive Planning for Important Health Care Decisions
INDIANA Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Organization
More informationOffender Living Will/Advance Directive for Health Care and Do Not Resuscitate (DNR) Consent
Offender Living Will/Advance Directive for Health Care... 1 and Do Not Resuscitate (DNR) Consent... 1 I. Living Will/Advance Directive... 1 II. Health Care Proxy... 2 III. Anatomical Gifts... 2 IV. Establishing
More informationSupport for this publication is provided by a grant from e Robert Wood Johnson Foundation, Princeton, New Jersey.
For more information contact: e National Hospice and Palliative Care Organization 1700 Diagonal Road, Suite 625 Alexandria, VA 22314 Call our HelpLine: 800/658-8898 Visit our Web site: www.caringinfo.org
More informationAdoption of the National Early Warning Score: a survey of hospital trusts in England, Northern Ireland and Wales
The UK s European university Adoption of the National Early Warning Score: a survey of hospital trusts in England, Northern Ireland and Wales Ugochi Nwulu, University of Kent Professor Jamie Coleman, University
More informationNEW JERSEY Advance Directive Planning for Important Health Care Decisions
NEW JERSEY Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CARINGINFO CaringInfo, a program of the
More informationAlcohol Units. A brief guide
Alcohol Units A brief guide 1 2 Alcohol Units A brief guide Units of alcohol explained As typical glass sizes have grown and popular drinks have increased in strength over the years, the old rule of thumb
More informationDirected Enhanced Service to provide health checks for people with Learning Disabilities
Directed Enhanced Service to provide health checks for people with Learning Disabilities 1. Introduction This is a Directly Enhanced Service for the provision of health checks for people with learning
More informationDo Not Resuscitate Directives in Kansas
Do Not Resuscitate Directives in Kansas Debra M. Sellers, Ph.D. Erin J. Dittman Understanding the Do Not Resuscitate (DNR) Directive DNR stands for Do Not Resuscitate. A DNR is a type of advance directive
More informationTimeline on administering and withholding/withdrawing treatment from severely brain injured patients:
Timeline on administering and withholding/withdrawing treatment from severely brain injured patients: The law and professional guidance Chronic Disorders of Consciousness York-Cardiff research centre V1
More informationMONTANA Advance Directive Planning for Important Health Care Decisions
MONTANA Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
More informationAdvance Directives for Health Care
Advance Directives for Health Care & Mental Health Care for ADVANCE HEALTH CARE DIRECTIVE EXPLANATION You have the right to give instructions about your own health care to the extent allowed by law. You
More informationNOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE
NOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE No one can predict when a serious illness or accident might occur. When it does, you may need someone else to speak or make health
More informationDPower of Attorney for Health Cared
State of Illinois Illinois Department of Public Health Illinois Statutory Short Form DPower of Attorney for Health Cared NOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE No one can
More informationIncapacity Benefit. Help if you re too ill or disabled to work. Part of the Department for Work and Pensions
Incapacity Benefit Help if you re too ill or disabled to work Part of the Department for Work and Pensions Are you too sick or disabled to work? If the answer is yes, you should read this leaflet. It will
More informationOREGON Advance Directive Planning for Important Health Care Decisions
OREGON Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
More informationFor more information about advance care planning, please visit our website at: www.advancecareplanning.ca. e-mail: info@advancecareplanning.
CHPCA and the Advance Care Planning project appreciate and thank their funding partners: Canadian Partnership Against Cancer and The GlaxoSmithKline Foundation. For more information about advance care
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 informationFLORIDA Advance Directive Planning for Important Health Care Decisions
FLORIDA Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
More informationHospice of the Western Reserve. Hospice and Palliative Care. Services for Serious, Chronic and Terminal Illnesses
Hospice of the Western Reserve Hospice and Palliative Care Services for Serious, Chronic and Terminal Illnesses A Tradition of Caring The leader in the community, Hospice of the Western Reserve is also
More informationFirst Aid as a Life Skill. Training Requirements for Quality Provision of Unit Standard-based First Aid Training
First Aid as a Life Skill Training Requirements for Quality Provision of Unit Standard-based First Aid Training New Zealand Qualifications Authority 2010 2 Index Introduction 3 Section One: Framework outline
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 information