herald

Sunday 24 September 2017

Dying patients need separate rooms -- study

Dying patients in hospitals should be given single rooms, according to a national audit of hospitals carried out at the behest of the Irish Hospice Foundation.

Most people indicate they would prefer to die at home, yet up to one-in-four patients who die in hospitals could have died in their own homes if there was sufficient support available.

The results of a national audit of end-of-life care in hospitals were released today at a conference in Dublin on the care of the dying in hospitals.

The Irish Hospice Foundation audit found significant differences in the assessment by doctors, nurses and relatives on the care of dying patients and the quality of their deaths. The proportion of "unacceptable deaths" is considerably higher in the assessment of relatives (21pc) than nurses (13pc) and doctors (3pc).

The audit was completed in 24 acute hospitals and in 19 community hospitals.

Also, a set of quality standards were launched today by the Minister for Health Mary Harney at the conference, which was developed by the Hospice Friendly Hospitals Programme.

The audit showed there are better care outcomes at end of life if:

nHospitals have end-of-life objectives in their plans

nDying patients have single rooms

nThere are adequate staffing levels



  • There are team meetings, especially between doctors and nurses


  • Nurses are formally trained in end-of-life or palliative care since qualifying


  • A nurse feels prepared for the death of a patient


  • Nurses are experienced


  • There is quality discussion with patients and relatives.

Meanwhile, new guidance issued to doctors today by the UK General Medical Council said terminally-ill patients should have the final say on their treatment when the risks and benefits are finely balanced.

While medics will not be expected to provide treatments which have no clinical benefit or that could do harm, they must pay attention to a patient's wishes.People who want to continue receiving food and fluids until the moment they die should normally be given them in cases where the benefits and harms carry a similar weight.

Equally, people who wish to die quickly can ask ahead of time for food and fluids to be withdrawn.

A patient's wishes around whether they are resuscitated should also be taken into account when doctors are deciding on treatment, according to the new guidance.

aokeeffe@herald.ie

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