Authors (including presenting author) :
TL Shum(1), WM Wong(1), PS Ko(2), SH Wong(1), Y Kwok(1), KP Chan(1), PC Hung(1)
Affiliation :
(1)Department of Medicine, Haven of Hope Hospital; (2) Nursing Services Division, United Christian Hospital
Introduction :
Nurses have an essential role to promote good quality End-of-life care (EOLC) for patients who are suffering from life-threatening illnesses. In our medical convalescence ward, the number of terminally ill patients is significant. In order to take care of these patients properly, we have initiated a systematic and multidisciplinary care program to help our frontline staff in providing a high quality care to our patients since April of 2017.
Objectives :
1.To standardize the nursing practice for patients who are imminently dying.
2.To enhance nursing service on end of life care for patients and their families.
3.To enhance palliative care knowledge of frontline nurses.
Methodology :
A working group on EOLC was formed and proposed a systematic and multidisciplinary care program for terminally ill patients. They reviewed and identified the gaps between the nursing care standard and current practice. A standardized “Care reminder for patients in the last days of life” has been used to unify the practice of EOLC. They also supervised and guided the junior nursing staff who accounted for over 30% of total nursing staff in our ward to provide appropriate care for terminally ill patients and their families. Nurse consultant (Palliative Care) conducted regular lectures and real case experience sharing in 2017 & 2018 in order to enhance their palliative care knowledge and skills. After implementation of the program, audit and evaluation were conducted.
Result & Outcome :
Totally 35 male patients with DNACPR were recruited in the program using “Care reminder for patients in the last days of life” from 1st January to 31th October 2018. 33 patients passed away and 2 patients got improvement in condition during hospitalization. Comparing with the rate of using the care reminder in last year, it has increased significantly from 45.7% to 81.3% of all patients with DNACPR order. The overall compliance rate of filling in the 4 parts of the care reminder is 98.2%. Moreover, the nursing staff, especially the junior ones, gave a positive feedback. It not only enhanced their awareness to provide high quality EOLC, but also equipped them with the skills and knowledge in provide systematic and patient-centered care to dying patients.
Co-location with:
