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End Of Life Care & Advanced Care Planning

This document is a summarised version of OP-CC5-Advanced Care Planning and End of Life Care. The summary has been created to be Emergency Department specific, and has been endorsed by the ED Leadership Team. Staff should review the PPG if they require further information.

Overview

This QRG provides staff with an overview of commencement of End of Life care within the Emergency Department.  Including the discussion of the patient’s end of life goals & wishes. This should take into account any advanced care planning they have previously had commenced & documented. At Emergency Department staff should access the End of Life Care folder found at the Nurse in Charge (NIC) desk.

Applicability

This QRG applies to all presentations to the Emergency Department.

 

Responsibility

It is the responsibility of the Nurse Unit Managers and Directors of the Emergency Departments of each site to ensure the relevant staff are familiar with this QRG, that it is implemented according to the guidelines as outlined within, and that there is compliance by all staff members.

Guideline Details

What is palliative care?

Palliative care involves the treatment of those with a serious illness or disease. Where the illness or disease has now reached a point where the process is no longer treatable & deemed to have irreversible causes.

Here treatment involves managing the person’s symptoms, ensuring that they & loved ones experience a good quality of life. Staff should remember this involves the person’s symptom management, psychological, spiritual & social needs. Good Palliative Care practices involve the patient and the family/carer in care decision making.

What is end of life care?

End of life care is a part of Palliative Care that is directed towards the person who is nearing the end of their life. This is usually focused on the last 6-12months, focusing on ensuring quality of life, allowing the person to pass with dignity & respect.

What is advanced care planning?

Involves the discussion of a person’s values & healthcare wishes for when they will no longer be able to discuss them due to becoming unwell.

What does this look like in practice?

  • Before commencing and advanced care planning paperwork ensure the medical officer has spoken with the family & patient.
  • Medical officer has complete advanced resuscitation plan.
  • Access the palliative care folder found at the nurse in charge deck.
  • Symptoms observation & management commenced.
  • Checklist of the dying patient in ED commenced.
  • Ensure there is breakthrough medications charted.
  • Attend to personal care needs & repositioning.
  • Provide family & patient education & support.
  • Arrange for air mattress & move to quite area if available.
  • Cease unnecessary monitoring & medications.
  • Contact pastoral care if needed.
  • Place purple life tree picture outside of patient’s room.
Figure 1: EOLC Purple Tree

 

Supporting Documents

  1. Advance Care Planning and End of Life Care

 

Document Governance

Title: End Of Life Care & Advanced Care Planning
Version: 2.0
Date Published: 01/08/2021
Date of scheduled review: 01/02/2022
Author: Approver:
ED Leadership Team ED Leadership Team