Luk, James KH.
End-of-life clinical plan in a geriatric step-down hospital [electronic resource] / James KH Luk, TC Chan, Winnie WY Mok, Ellen KC Wong, Felix HW Chan - pp. 42-47.
The mean duration of EOL-CPi activation was 4.15 days. The principal diagnosis of patients included advanced dementia (49.2%), active cancer (26.5%), neurodegenerative disease (11.7%), organ failure (8.6%), and stroke (4%). In the last 24 hours before death, 99.2% of patients were pain-free, not agitated, and without excessive secretions.
In the same group of patients, compared with pre-EOL-CPi, post-EOLCPi resulted in a significant reduction in use of intravenous antibiotics (87.5% vs. 55%, p<0.001), road-spectrum antibiotics (61% vs. 36%, p<0.001), blood product transfusion (10% vs. 2.3%, p<0.05), physical restraints (28% vs. 9.3%, p<0.001), blood tests (82% vs. 14%, p<0.001), haemoglucostix monitoring (40% vs. 15.6%, p<0.001), oxygen use (8 vs. 6.7 L/min, p<0.001), the number of regular medications per patient (5.1 vs. 2.3, p<0.001), and the number of ‘as needed’ medications per patient (3.9 vs. 3.7, p=0.016). 92% family members were able to say goodbye to their dying relative; 95% had after-death procedures discussed and implemented; 95% of family members were given information about after-death procedures; 93% had family emotions handled.
The EOL-CPi was useful to guide management of dying older patients in a geriatric step-down hospital. A further prospective randomised control trial is warranted to determine the benefits of EOLCPi.
Mode of access: Internet.
Clinical protocols; Geriatric nursing; Terminal care
End-of-life clinical plan in a geriatric step-down hospital [electronic resource] / James KH Luk, TC Chan, Winnie WY Mok, Ellen KC Wong, Felix HW Chan - pp. 42-47.
The mean duration of EOL-CPi activation was 4.15 days. The principal diagnosis of patients included advanced dementia (49.2%), active cancer (26.5%), neurodegenerative disease (11.7%), organ failure (8.6%), and stroke (4%). In the last 24 hours before death, 99.2% of patients were pain-free, not agitated, and without excessive secretions.
In the same group of patients, compared with pre-EOL-CPi, post-EOLCPi resulted in a significant reduction in use of intravenous antibiotics (87.5% vs. 55%, p<0.001), road-spectrum antibiotics (61% vs. 36%, p<0.001), blood product transfusion (10% vs. 2.3%, p<0.05), physical restraints (28% vs. 9.3%, p<0.001), blood tests (82% vs. 14%, p<0.001), haemoglucostix monitoring (40% vs. 15.6%, p<0.001), oxygen use (8 vs. 6.7 L/min, p<0.001), the number of regular medications per patient (5.1 vs. 2.3, p<0.001), and the number of ‘as needed’ medications per patient (3.9 vs. 3.7, p=0.016). 92% family members were able to say goodbye to their dying relative; 95% had after-death procedures discussed and implemented; 95% of family members were given information about after-death procedures; 93% had family emotions handled.
The EOL-CPi was useful to guide management of dying older patients in a geriatric step-down hospital. A further prospective randomised control trial is warranted to determine the benefits of EOLCPi.
Mode of access: Internet.
Clinical protocols; Geriatric nursing; Terminal care
Hong Kong Nang Yan College of Higher Education
Lee Yan Fong Library
325-329 Lai Chi Kok Road, Shamshuipo, Kowloon, HONG KONG
Lee Yan Fong Library
325-329 Lai Chi Kok Road, Shamshuipo, Kowloon, HONG KONG