The second National Care of the Dying Audit of Hospitals (NCDAH) shows that patients on the Liverpool Care Pathway for the Dying Patient (LCP) are receiving high quality care. The audit covers the use of the LCP in 155 hospitals, looking at the records of almost 4,000 patients.
The audit showed that, even in their last 24 hours, 65% of patients needed no continuous subcutaneous infusion of medication to control distress from agitation or restlessness – 31% had low doses of medication to relieve symptoms delivered by a subcutaneous infusion, while the remaining 4% required higher doses. These findings indicate, that dying patients receive good clinical care, tailored to the individual and their distress, when supported by the LCP.
The LCP supports the management of distress caused by agitation and restlessness in dying patients with medication given at an appropriate dose in relation to the severity of the symptom. In the last 24 hours of life the vast majority of patients were reported to be comfortable, while progress has been achieved in the area of privacy and dignity, with an increase in the availability of side rooms.
Professor John Ellershaw, director, Marie Curie Palliative Care Institute Liverpool, said: “Hospitals need to recognise that care of the dying is part of their core business. To achieve excellence in the last hours and days of a patient’s life, all healthcare workers caring for dying patients and their relatives should undertake training and education in care of the dying. A good death should be the expected not the exception.”
