GUIDELINES ON SYMPTOM CONTROL & END OF LIFE CARE IN AN ACUTE HOSPITAL
Introduction: Many patients die in acute hospitals under the care of clinical teams and may or may not require specialist palliative care input. Current Medical Council recommendations in Ireland advise that doctors should treat patients who are dying with dignity, optimize comfort and it recognizes family's communication needs. These guidelines were developed as part of an audit of symptom control of patients at the end of life in an acute hospital.
Aims and objectives: To create a guideline to facilitate symptom management and care planning for patients who are imminently dying and to empower non-palliative care medical practitioners in their clinical decision making.
Method: A collaborative, interdisciplinary, interdepartmental process was involved in developing the guidelines.
Results: The guidelines were developed based on current evidence, palliative care practice, and feedback from the consultative process. They were presented to the doctors at Induction. Hard copies were printed, laminated and made available on the wards.
The guidelines include medication management, clinical practice and communication issues. They consist of prompts to aid individualized, patient-centered, clinical decision making including addressing reversible causes for deterioration if appropriate and consideration of the ceiling of care. Options for anticipatory symptom control medications and the patient's environmental setting were incorporated. Specialist palliative care advice and involvement can be sought at any stage of management.
Conclusion: The guidelines were developed to aid timely, effective, patient focused care for patients who are imminently dying and to support non-palliative medical practitioners in end of life care.