COMPARISON OF DOCUMENTED PATIENT CARE BEFORE AND AFTER IMPLEMENTATION OF END OF LIFE CARE PATHWAY FOR TERMINALLY ILL PATIENTS AT SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE

Irum Ghafoor, Haroon Hafeez, Farhat Naz, Muhammad Abu Baker
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Abstract

Purpose: Shaukat Khanum Memorial Cancer Hospital and Research Cancer primarily deals with cancer patients and has various departments which provide best-integrated lifesaving care. However, when patients who have been given all possible medical and oncological treatment still progress their disease, they are then referred for best supportive care to palliative care department. The aim of this paper was to audit documented care for palliative patients before and after implementation of end of life care (ELC) pathway.Materials and Methods: We used a retrospective method to audit 45 terminally ill patients over a period of 3 months. Then, a re-audit was done over a period of 3 months and data were collected for patients who were started on SKM-ELC pathway.Results: Results show that the implementation of ELC pathway, 67% of the patients were not prescribed PRN medications for symptom control, 20% of the patients were not reviewed for the need of assisted nutrition and for 20% of the patient’s primary team were not even notified that the patient is dying. After the ELC pathway implementation, it was found that 100% of patients were reviewed for PRN medications and assisted nutrition. Oncologists were timely notified that the patient is dying.Conclusion: In summary, we can say that implantation of ELC pathway has significantly improved documented patients care in all aspects.Key words: Cancer, care for dying, end of life care, goals of care pathway
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shaukat khanum纪念癌症医院和研究中心实施临终关怀路径之前和之后记录的患者护理的比较
目的:Shaukat Khanum纪念癌症医院和癌症研究中心主要治疗癌症患者,并设有各种部门,提供最佳的综合救生护理。然而,当患者在接受了所有可能的医疗和肿瘤治疗后,病情仍在恶化时,他们会被转介到姑息治疗部门接受最佳支持性治疗。本文的目的是审计临终关怀(ELC)途径实施前后姑息治疗患者的记录护理。材料与方法:采用回顾性方法对45例晚期患者进行为期3个月的审计。然后,在3个月的时间内进行重新审核,并收集开始SKM-ELC途径的患者的数据。结果:结果显示,在实施ELC途径后,67%的患者未开PRN药物进行症状控制,20%的患者未复查是否需要辅助营养,20%的患者主治团队甚至未通知患者即将死亡。在ELC途径实施后,发现100%的患者接受了PRN药物和辅助营养的检查。肿瘤学家及时得到通知,病人即将死亡。结论:综上所述,我们可以说ELC通路的植入在各方面显著改善了文献患者的护理。关键词:癌症;临终关怀;临终关怀
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