Authors (including presenting author) :
Lam SK, Cheng TK, Ng HY, Ma SY, Wong MS, Wong MSP, Cheung KK, Lam PT, Tsang WY, Ng YB
Affiliation :
Palliative Care Unit, Department of Medicine and Geriatrics, United Christian Hospital
Introduction :
Dying is an inevitable life event in the life continuum. Good end-of-life care (EOLC) is an essential element to allow patients dying with dignity and comfort; and their families being supported. Since June 2019, ‘Care Reminder for Patients in the Last Days of Life’ (CRPLDL) revised from ‘Care Checklist for the Imminently Dying’ is piloted in a mixed Palliative Care and Rehabilitation ward (2D) in United Christian Hospital (UCH), to provide guidance for healthcare professionals in providing EOLC.
Objectives :
This study is to understand nurses’ perception and experience of taking care of EOL patients and their families, and the using of the “Care Reminder for Patients in the Last Days of Life” (CRPLDL).
Methodology :
Staff survey on EOLC and use of CRPLDL was conducted in UCH ward 2D. Nurses with no prior EOLC training were included. A questionnaire was designed. It combined closed and open-ended questions. The questionnaires were distributed by the surveyors, then completed and returned by participants with anonymity.
Result & Outcome :
There were ten eligible nurses for this pilot study (n=10). All of them are female. They completed the questionnaire from December 2019 to January 2020. 7 of them with working experience less than 2 years, while the others are all over 10 years. 3 of them had no experience in taking care of patients in their last days of life and their families before having the CRPLDL. Identifying high risk family member for complicated grief (mean score 2.4) was found most challenging to the respondents, followed by managing own emotional distress (e.g. anger, grief) (mean score 2.6), with 1 represents most challenging and 5 represents not at all challenging. 6 of the respondents have experience in using the CRPLDL. All nurses show positive feedback to the CRPLDL. All of them perceived that the CRPLDL was effective in reminding them on quality care and changing their practice in providing EOLC. The mean score on the easiness and effectiveness in using the CRPLDL is 3.7 and 3.8 respectively (1 represents not at all positive and 5 represents most positive). Most respondents think that the CRPLDL is beneficial in facilitating communication among healthcare professionals while most encountered the difficulty of patient’s condition deteriorates too quickly to use the CRPLDL. All respondents expressed that they would actively use the CRPLDL in EOLC in the future.
In conclusion, nurses showed positive responses to the use of the CRPLDL, their expressed challenges and difficulties in EOLC inform their training needs. In order to better prepare nurses for quality of EOLC, more training and educational programs are recommended.
