This is how we do it, an audit on end of life care decision in critical care unit NMUH (Record no. 76368)
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fixed length control field | 02744cam a2200181 4500 |
001 - CONTROL NUMBER | |
control field | NMDX7488 |
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
fixed length control field | 120401t2016 xxu||||| |||| 00| 0 eng d |
100 ## - MAIN ENTRY--PERSONAL NAME | |
Personal name | Tharmalingam, B. |
240 ## - UNIFORM TITLE | |
Uniform title | <a href="Intensive Care Medicine Experimental">Intensive Care Medicine Experimental</a> |
245 ## - TITLE STATEMENT | |
Title | This is how we do it, an audit on end of life care decision in critical care unit NMUH |
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT) | |
Date of publication, distribution, etc. | 2016 |
500 ## - GENERAL NOTE | |
General note | NMUH Staff Publications |
500 ## - GENERAL NOTE | |
General note | EMBASE |
500 ## - GENERAL NOTE | |
General note | 4 |
520 ## - SUMMARY, ETC. | |
Summary, etc. | <span style="font-size: 10pt;">Majority of death occur in critical care unit (CCU) after withdrawal/withholding of treatment. Our aim was to analyse the documentation of the complex issues surrounding end of life care (EOL) decision in our CCU. We collected data about our CCU practice of EOL decision and compared with the best practice recommended by Royal college of Anaesthetist in 2012. Our goal was to improve the quality of care of the patients with EOL in our CCU. It's a retrospective audit. All the patients in CCU for whom the decision of withdrawal of life prolonging treatment from 01/04/2014-31/03/2015 were included in this study. The data was taken from ACUBASE electronic notes and CCU monitoring charts of the relevant cases and analysed using Microsoft EXCEL. Out of the 217 deaths in CCU 81 (37.3 %) were due to withdrawal of treatment. We had found the excellent documentation regarding family discussion (93.8 %) and formal decision of withdrawal of support (83.9 %). All the patients (100 %) had valid DNACPR form. The documentation of method of withdrawal was 59.2 %, on the other hand the treatment limitation on admission as advanced care plan, documentation of patient discussion about EOL, consideration of spiritual aspect, time of withdrawal, organ donation were documented in 22 %,2 %,12 %,16 % and 30 % of cases respectively. In the method of withdrawal we audited the organ supports and symptom relief medications. Only 73 % of the patients had analgesics and 26 % had sedatives during the process of dying. This is because the prescription was done in drug chart. Feeds/fluids were continued in 78 % of patients. As a result of this audit we proposed the following actions To formulate a template in ACUBASE with essential elements of EOL which will be filled by the relevant CCU consultant and copy of it will be handed over to the bed side nurse for further care. The time of withdrawal will be documented by the bed side nurse after family gathering and fulfilment of spiritual aspects in the monitoring chart and the doctor who certifies the death will document it on the ACUBASE.&nbsp;</span> |
700 ## - ADDED ENTRY--PERSONAL NAME | |
Personal name | Kovari, F. |
856 ## - ELECTRONIC LOCATION AND ACCESS | |
Uniform Resource Identifier | <a href="https://icm-experimental.springeropen.com/track/pdf/10.1186/s40635-016-0099-9?site=icm-experimental.springeropen.com">https://icm-experimental.springeropen.com/track/pdf/10.1186/s40635-016-0099-9?site=icm-experimental.springeropen.com</a> |
Withdrawn status | Lost status | Damaged status | Not for loan | Collection code | Home library | Current library | Shelving location | Date acquired | Total Checkouts | Date last seen | Price effective from | Koha item type |
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Staff publications for NMDX | Ferriman information and Library Service (North Middlesex) | Ferriman information and Library Service (North Middlesex) | Shelves | 07/06/2022 | 07/06/2022 | 07/06/2022 | Book |