Palliative care need and management in the acute hospital setting: a census of one New Zealand Hospital

BMC Palliative Care

Research Article

Rosemary Frey¹  Deborah Raphael¹  Merryn Gott¹  Anne O’Callaghan²  Jackie Robinson²  Michal Boyd³ 

[1] Faculty of Medical and Health Sciences, University of Auckland, Building 505, 85 Park Road, Grafton, New Zealand;Faculty of Medical and Health Sciences, University of Auckland, Building 505, 85 Park Road, Grafton, New Zealand;Auckland District Health Board, Auckland, New Zealand;Faculty of Medical and Health Sciences, University of Auckland, Building 505, 85 Park Road, Grafton, New Zealand;Waitemata District Health Board, Westlake, New Zealand;

关键词: Palliative care;    End of life;    Census;    Healthcare;    Acute;    Hospital;   

DOI  :  10.1186/1472-684X-12-15

 received in 2012-10-16, accepted in 2013-03-21,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundImproving palliative care management in acute hospital settings has been identified as a priority internationally. The aim of this study was to establish the proportion of inpatients within one acute hospital in New Zealand who meet prognostic criteria for palliative care need and explore key aspects of their management.MethodsA prospective survey of adult hospital inpatients (n = 501) was undertaken. Case notes were examined for evidence that the patient might be in their last year of life according to Gold Standards Framework (GSF) prognostic indicator criteria. For patients who met GSF criteria, clinical and socio-demographic information were recorded.ResultsNinety-nine inpatients met GSF criteria, representing 19.8% of the total census population. The patients’ average age was 70 years; 47% had a primary diagnosis of cancer. Two thirds had died within 6 months of their admission. Seventy-eight of the 99 cases demonstrated evidence that a palliative approach to care had been adopted; however documentation of discussion about goals of care was very limited and only one patient had evidence of an advance care plan.ConclusionOne fifth of hospital inpatients met criteria for palliative care need, the majority of whom were aged >70 years. Whilst over three quarters were concluded to be receiving care in line with a palliative care approach, very little documented evidence of discussion with patients and families regarding end of life issues was evident. Future research needs to explore how best to support ‘generalist’ palliative care providers in initiating, and appropriately recording, such discussions.

【 授权许可】

Unknown   
© Gott et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.