Anne M Wilkinson1, Claire E Johnson2, Helen Walker3, Valerie Colgan3, Hayley Arnet4, Tapan Rai5. 1. Centre for Cancer and Palliative Care Research, School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Blvd., Bldg. 21.460, Joondalup, Western Australia, 6027, Australia. anne.wilkinson@ecu.edu.au. 2. School of Surgery, The University of Western Australia, Perth, Western Australia, Australia. 3. Department of Health, Palliative Care, WA Cancer and Palliative Care Network, Perth, Western Australia, Australia. 4. Centre for Cancer and Palliative Care Research, School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Blvd., Bldg. 21.460, Joondalup, Western Australia, 6027, Australia. 5. School of Mathematical Sciences, University of Technology Sydney, Ultimo, New South Wales, Australia.
Abstract
PURPOSE: This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia. METHODS: The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation. RESULTS: Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p ≤ 0.000), use of palliative medications (pre-87 %, post-98 %; p ≤ 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p ≤ 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period. CONCLUSIONS: This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families.
PURPOSE: This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia. METHODS: The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation. RESULTS: Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p ≤ 0.000), use of palliative medications (pre-87 %, post-98 %; p ≤ 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p ≤ 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period. CONCLUSIONS: This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families.
Entities:
Keywords:
Critical pathways; Palliative care; Quality improvement; Quality of health care; Terminal care
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