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The French Ministerial decree DHOS/02/2008/99 (25/03/2008) described a gradation in palliative care and created ‘designated palliative care beds’. Intermediate between ‘classical’ beds in regular clinical departments and ‘specialised’ beds in palliative care units, these designated palliative care beds are located within clinical departments that are not dedicated to palliative care, but frequently faced with death or final days of terminally ill patients. This study reports consequences of the creation of a designated palliative care bed in a surgery department specialised in head and neck cancer.
Retrospective study between 1st September 2010 and 31st August 2011 of 17 patients hospitalised in the new created designated palliative care beds.
Seventy-seven percent of patients hospitalised in our ENT department with ‘palliative care’ as main diagnosis benefited from global care by their ENT, psychologist and palliative mobile care team as they were hospitalised in designated palliative care beds. Seventy-one percent of patients were fed by gastrostomy; 76% had a tracheotomy, and 71% needed a regular new dressing. Survival indicators such as serum albumin, LDH concentration, number of metastatic sites and Karnofsky index helped to define patients needing to be transferred in a palliative care unit. Median duration of hospitalisation was 13 days; 41% patients died in our department, the remaining were either transferred in a palliative care department, or sent back home thanks to a palliative network.
Creating a designated palliative care bed instructed our surgical department staff in palliative care and improved communication between palliative mobile care team, ENT, psychologists and paramedical staff, improving the quality of care. Protocols were written and quality of care increased without increasing global workload. Using survival prognosis criteria made dialogue with palliative care unit easier.
Médecine Palliative Soins de Support - Accompagnement - Éthique 05/2014;
Archives des Maladies du Coeur et des Vaisseaux - Pratique 01/2014; 2014(224):24–26.
Archives des Maladies du Coeur et des Vaisseaux - Pratique 12/2013; 2013(223):18–22.
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