The Liverpool Care Pathway (LCP) influencing the UK national agenda on care of the dying
Available from: Tessa Watts
- "Nevertheless, concluding their discussion of the LCP's influence on end-of-life care, Ellershaw and Murphy (2005), important and influential contributors to this field, identified that 'optimising symptom control' (p. 134) required attention. "
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ABSTRACT: This paper calls into question whether and how end-of-life care pathways facilitate the accomplishment of a 'good death'. Achieving a 'good death' is a prominent social and political priority and an ideal which underpins the philosophy of hospice and palliative care. End-of-life care pathways have been devised to enhance the care of imminently dying patients and their families across care settings and thereby facilitate the accomplishment of a 'good death'. These pathways have been enthusiastically adopted and are now recommended by governments in the UK as 'best practice' templates for end-of-life care. However, the literature reveals that the 'good death' is a nebulous, fluid concept. Moreover, concerns have been articulated regarding the efficacy of care pathways in terms of their impact on patient care and close analysis of two prominent end-of-life pathways reveals how biomedical aspects of care are privileged. Nonetheless drawing on a diverse range of evidence the literature indicates that end-of-life care pathways may facilitate a certain type of 'good death' and one which is associated with the dying process and framed within biomedicine.
Available from: canadianoncologynursingjournal.com
- "À l'origine, cet outil a été mis au point au Royaume-Uni à titre de fondement pour la formation sur la fin de vie à l'intention des prestataires de soins et a plus récemment été utilisé comme modèle dans la normalisation des soins aux patients en fin de vie et à leurs proches, y compris la manière dont ils abordent les transitions entre systèmes experts. Une étude multicentrique sur les effets de l'application de ce cheminement clinique s'est soldée par des résultats démontrant une amélioration du fardeau des symptômes et de la documentation (Ellershaw & Murphy, 2005). Je suis frappée par le fait que cet outil soit un prolongement de l'approche structurée et fondée sur des données probantes des soins aux patients pour laquelle le système expert des soins de cancérologie a déjà fait ses preuves. "
Available from: Anthony James P Clover
- "The LCP provides education and feedback to professionals involved in terminal care and identifies room for improvement by highlighting areas where goals have not been attained . LCP delivered care also has an effect on relatives as levels of bereavement are statistically significantly lower in relatives of those treated by the LCP when compared to those not treated [ "
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ABSTRACT: Despite advances in burn care some injuries remain non survivable. Good end of life care for these patients is arguably as important as life prolonging care. The Liverpool Care Pathway is a useful tool for providing good quality end of life care. It has previously been modified for the acute setting. We modified it further specifically for use in burn care in 2007 and would like to share our experience of using it.
A retrospective case series of deaths occurring between 01/01/08 and 31/12/09 is presented and adherence to the Burn Modified Liverpool Care Pathway (BM-LCP) is assessed.
There were 22 deaths over the study period with a mean TBSA of 55%. Mean Acute Burn Severity Index score (ABSI) 12.5. A decision of futility was made in 14 cases, 11 of these were started on the BM-LCP. 7 were started on the pathway at the time of admission. Mean time from decision to start the pathway to death 11 h (range 3-48). There were no variances from the pathway.
The BM-LCP appears to be an appropriate tool for assisting in end of life care in burns and when used appears to improve end of life care. We recommend its use and would encourage others to implement its use.
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