Care of the dying audit action plan - Areas Requiring Improvement
by maria debattista
1. Reduced Recognition of Dying patients - Reduction in number of patients in whom death was recognised from 98% to 86%, decreased discussion with patients and nominated persons, increase in length of time from recognition to death, Increase in time from admission to recognition.
1.1. Education
1.2. Integrated working
2. Reduction in number of DNACPR orders completed, but more importantly reduction in discussions with patients and families
2.1. Resuscitation Team
2.2. Education
3. Higher than national average of patients dying on ventilation and dialysis with a reduction in senior review and discussions around appropriateness of continuing active treatment.
3.1. L Holt
4. Care during and after death - Notification of patients that are imminently dying, provision of verbal and written information, support of the patient’s family and those important to them at the time of/immediately after death
4.1. Bereavement Team
4.1.1. Link nurses
5. Individualised Plan of care - Reduction in assessment of anticipated symptoms, and prescribing (although prescribing still above national average)
5.1. Individualised plan of Care
5.1.1. Memo out to cconsultnats
5.1.2. Quality and Safety oard
5.1.3. Matrons Escalation
5.2. Doctors Induction
5.3. Transfrom
5.4. NMP Prescribing
5.5. Link Nurses and Audit
5.6. Follow up visits Ward Areas - Ward Manager
5.7. Checker
5.8. Mandatory care plan?
6. Hydration and Nutrition Needs - Need for improved assessment of eating and drinking, and Communication of care plan
7. Decrease in number of patients were there was a discussion re spiritual/cultural/religious needs with the patient or those important to them
8. Complete Report
8.1. Conclusions
8.2. Table
8.3. Template
9. Link Nurses - LD/JD/JA/NM
10. Review Care Plan
11. Patient and Safety Collaborative
12. Cascade Senior staff
12.1. Clinical Directors Email
12.2. matrons Email - JD
12.3. Medical Leadership
12.4. EOLCB
13. Audit Activity
13.1. Shortened Version of Audit - Rolling Ward Audits - Last 5 deaths -LD
13.1.1. RBS
13.1.2. 18
13.1.3. 23
13.1.4. Rockwood
13.1.5. 20
13.1.6. 21
13.1.7. Surgery