BACKGROUND: The literature contains limited information on the problems faced by dying patients with COVID-19 and the effectiveness of interventions to manage these. AIM: The aim of this audit was to assess the utility of our end-of-life care plan, and specifically the effectiveness of our standardised end-of-life care treatment algorithms, in dying patients with COVID-19. DESIGN: The audit primarily involved data extraction from the end-of-life care plan, which includes four hourly nursing (ward nurses) assessments of specific problems: patients with problems were managed according to standardised treatment algorithms, and the intervention was deemed to be effective if the problem was not present at subsequent assessments. SETTING/PARTICIPANTS: This audit was undertaken at a general hospital in England, covered the 8 weeks from 16 March to 11 May 2020 and included all inpatients with COVID-19 who had an end-of-life care plan (and died). RESULTS: Sixty-one patients met the audit criteria: the commonest problem was shortness of breath (57.5%), which was generally controlled with conservative doses of morphine (10-20 mg/24 h via a syringe pump). Cough and audible respiratory secretions were relatively uncommon. The second most common problem was agitation/delirium (55.5%), which was generally controlled with standard pharmacological interventions. The cumulative number of patients with shortness of breath, agitation and audible respiratory secretions increased over the last 72 h of life, but most patients were symptom controlled at the point of death. CONCLUSION: Patients dying of COVID-19 experience similar end-of-life problems to other groups of patients. Moreover, they generally respond to standard interventions for these end-of-life problems.
BACKGROUND: The literature contains limited information on the problems faced by dying patients with COVID-19 and the effectiveness of interventions to manage these. AIM: The aim of this audit was to assess the utility of our end-of-life care plan, and specifically the effectiveness of our standardised end-of-life care treatment algorithms, in dying patients with COVID-19. DESIGN: The audit primarily involved data extraction from the end-of-life care plan, which includes four hourly nursing (ward nurses) assessments of specific problems: patients with problems were managed according to standardised treatment algorithms, and the intervention was deemed to be effective if the problem was not present at subsequent assessments. SETTING/PARTICIPANTS: This audit was undertaken at a general hospital in England, covered the 8 weeks from 16 March to 11 May 2020 and included all inpatients with COVID-19 who had an end-of-life care plan (and died). RESULTS: Sixty-one patients met the audit criteria: the commonest problem was shortness of breath (57.5%), which was generally controlled with conservative doses of morphine (10-20 mg/24 h via a syringe pump). Cough and audible respiratory secretions were relatively uncommon. The second most common problem was agitation/delirium (55.5%), which was generally controlled with standard pharmacological interventions. The cumulative number of patients with shortness of breath, agitation and audible respiratory secretions increased over the last 72 h of life, but most patients were symptom controlled at the point of death. CONCLUSION:Patients dying of COVID-19 experience similar end-of-life problems to other groups of patients. Moreover, they generally respond to standard interventions for these end-of-life problems.
Authors: Bregje D Onwuteaka-Philipsen; H Roeline W Pasman; Ida J Korfage; Erica Witkamp; Masha Zee; Liza Gg van Lent; Anne Goossensen; Agnes van der Heide Journal: Palliat Med Date: 2021-04-07 Impact factor: 4.762
Authors: Aaron K Wong; Lucy Demediuk; Jia Y Tay; Olivia Wawryk; Anna Collins; Rachel Everitt; Jennifer Philip; Kirsty Buising; Brian Le Journal: Intern Med J Date: 2021-09 Impact factor: 2.611
Authors: Gehan Soosaipillai; Anjui Wu; Gino M Dettorre; Nikolaos Diamantis; John Chester; Charlotte Moss; Juan Aguilar-Company; Mark Bower; Christopher Ct Sng; Ramon Salazar; Joan Brunet; Eleanor Jones; Ricard Mesia; Amanda Jackson; Uma Mukherjee; Ailsa Sita-Lumsden; Elia Seguí; Diego Ottaviani; Anna Carbó; Sarah Benafif; Rachel Würstlein; Carme Carmona; Neha Chopra; Claudia Andrea Cruz; Judith Swallow; Nadia Saoudi; Eudald Felip; Myria Galazi; Isabel Garcia-Fructuoso; Alvin J X Lee; Thomas Newsom-Davis; Yien Ning Sophia Wong; Anna Sureda; Clara Maluquer; Isabel Ruiz-Camps; Alba Cabirta; Aleix Prat; Angela Loizidou; Alessandra Gennari; Daniela Ferrante; Josep Tabernero; Beth Russell; Mieke Van Hemelrijck; Saoirse Dolly; Nicholas J Hulbert-Williams; David J Pinato Journal: Ther Adv Med Oncol Date: 2021-09-02 Impact factor: 8.168
Authors: Lawrence Mbuagbaw; Zainab Samaan; Emma A van Reekum; Tea Rosic; Anjali Sergeant; Nitika Sanger; Myanca Rodrigues; Reid Rebinsky; Balpreet Panesar; Eve Deck; Nayeon Kim; Julia Woo; Alessia D'Elia; Alannah Hillmer; Alexander Dufort; Stephanie Sanger; Lehana Thabane Journal: J Med Case Rep Date: 2021-12-13