The current issue of Nursing Times features the findings of a (UK) audit of patients with palliative care needs. The findings point to poor communication, equipment shortages, difficulties transferring patients to care pathways and lack of cooperation between hospitals and social care networks as causing delayed discharge for palliative patients.
Wednesday’s Hospice Friendly Hospitals conference ‘End-of-life care; from the margins to the mainstream’ saw the launch of the report on the first ‘National audit of end-of-life care in Hospitals in Ireland’ and the new ‘Quality standards for end-of-life care in Hospitals’
These publications mark the end of phase one of the Hospice Friendly Hospitals programme and represent a significant contribution to the understanding of current practice and future development of end-of-life services in Ireland. The audit, which surveyed end of life care in 24 acute hospitals (75 % of the acute sector) and 19 community hospitals (20% of community sector) presents a unique multi dimensional approach to assessing death and dying in Irish hospitals illustrating the varying perspectives on quality of care at end of life from doctors, nurses, hospital staff patients and relatives.
Among the audit findings are;
20/25% of patients could have died at home were adequate supports in place
Information given to patients’ relatives is often not adequate
Quality levels vary across diseases with cancer at the high end of the spectrum and dementia at the lower end
The hospitals treatment of the family has a lasting effect
The Quality standards, launched by Minister Mary Harney at Wednesdays conference were developed as a framework around which to implement quality care. They have been arranged around the four key areas of Hospital – Staff – Patient -Family and aim to provide access points from which hospitals can integrate compassion and communication into processes and practice.