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Coordinated Administer to THE Grown-up Kicking the bucket Tolerant IN Consideration HOMES. Julie Williams Macmillan Clinical Medical attendant Master Nursing Homes 4 th July 2008. Points OF THIS PRESENTATION. To present the Coordinated Consideration Pathway (ICP) for the grown-up passing on patient

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Incorporated CARE PATHWAY FOR THE ADULT DYING PATIENT IN CARE HOMES Julie Williams Macmillan Clinical Nurse Specialist Nursing Homes 4 th July 2008

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AIMS OF THIS PRESENTATION To present the Integrated Care Pathway (ICP) for the grown-up kicking the bucket patient To depict the effect of possibly poor care of a diminishing Patient Describe and diagram how the pathway fits with the more extensive national plan

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INTEGRATED CARE PATHWAY (ICP) A DEFINITION A coordinated care pathway decides privately concurred multidisciplinary rehearse, in light of rules and proof where accessible, for a particular patient/customer aggregate. It frames all or some portion of a clinical record, reports the care given and encourages the assessment of results for proceeding with quality change". (National Pathways Association 1998)

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1. What is the ICP? It was produced and started by the palliative care group in Liverpool. Liverpool Care Pathway (LCP) A guide/apparatus/structure for the conveyance of arranged care to the inhabitant amid the diminishing stage It is a multi-proficient report Provides a strategy for planning and institutionalizing care – decreasing practice varieties

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2. What is the ICP? A confirmation based authoritative record, fusing rules which reflect current great practice Provides a system for consistently observing and assessing procedures, practices and results of care conveyed It points of interest assignments, groupings and timescales. It has been created to exchange to all care settings.

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The ICP is NOT A feedback of current practice Totally prescriptive Just a nursing report Undermining of expert information, aptitude and skill Complicated WRITTEN IN STONE

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1. How the ICP Relates To The National Agenda For End Of Life Care The Cancer Plan (2000) National Service Framework for Coronary Heart Disease (2000) National Service Framework for Older People (2001) The Gold Standards Framework (2003) Cancer Services Collaborative Improvement Partnership (2003 )

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2. How the ICP Relates To The National Agenda For End Of Life Care Building on the Best, Choice, Responsiveness and Equity in the NHS (2003) National Service Framework for Renal Services (2004) National Service Framework for Long Term Conditions (2005) Our Health, Our Say (2006) Building on Firm Foundations-Improving end of life care in care homes (2007)

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3. How the ICP Relates To The National Agenda For End Of Life Care NICE rules Improving Supportive and Palliative Care for Adults with Cancer (2004) states "In all areas the specific needs of patients who are kicking the bucket ought to be recognized and tended to. The Liverpool Integrated Care Pathway gives one system to accomplishing this." All national suggestions have highlighted the significance of decision and an incorporated wellbeing and social care way to deal with end of life care

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The effect of possibly poor care of a withering inhabitant Complaints Influence on the mourning procedure Staff and relative disappointment " What may have been"

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1.. Why actualize the ICP in Care Homes? 56% of passings happen in healing centers (2003) 64% of patients would like to bite the dust in their own particular homes(2004) 17% passings happen in care homes (2008 Professor Mike Richards) Reduces emergency admissions to clinic in the withering stage

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2. Why Implement the ICP in Care Homes? To empower occupants to pass on gently in their home To empower relatives and carers to give care, be kept educated and have positive enduring recollections if conceivable Staff included have a feeling of fulfillment that a "decent demise" has been accomplished

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Promotes proactive high caliber, proficient, viable and impartial care Enhances great correspondence and collaboration Gives authorization to end administrations Informs on side effect control It can spare time and lessen documentation. It avoids emergency mediation 1. Advantages of utilizing the ICP in Care Homes

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Empowers and builds staff ability and trust in watching over passing on occupants and their families Sensitive, One record Up to date - gives confirmation of value care given to inhabitants and families It can highlight and recognize instruction, preparing and asset needs. It advances the successful utilization of assets It can avoid redundancy It gives information to review and intelligent practice 2. Advantages of utilizing the ICP in Care Homes

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Considerations For Inclusion On The On The ICP The inhabitant has a known irreversible life debilitating disease of any etiology. Reversible reasons for the occupant's present disintegration have been considered and suitably overseen. Serious care and revival have been talked about by the group and have been considered improper.

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Criteria For Inclusion On The ICP The Multidisciplinary Team has concurred that the inhabitant is kicking the bucket and 2 of the accompanying apply The occupant is bed bound The occupant is semi-senseless The inhabitant is just ready to take tastes of liquid The inhabitant is no longer ready to take tablets

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1.Components Of The ICP Initial evaluation Ongoing appraisal and documentation of care on a 4 and 12 hourly premise Outcome Measures (Goals) for each segment Variance recording Goal Achieved (A) Goal not accomplished ("V" for Variance)

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2.Components Of The ICP Multidisciplinary correspondence/advance record sheets Information for family and carers Care after death Guidelines for staff Symptom control Guidelines

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Analyzing and examining the finished documentation. Finished pathways are broke down and information is entered onto a database Pathways are inspected every year Feedback is accessible to taking an interest zones

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When would we be able to begin actualizing the ICP in Care Homes? Pilot in 4 GSF authorize Nursing Homes in Kirklees Education required before ICP usage Liverpool Care Pathway National group will bolster the Pilot in the 4 Nursing Homes

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WE ONLY HAVE THE ONE CHANCE TO GET IT RIGHT People may not recall precisely what you did or what you do But they will never forget how you affected them "Disease me and Serenity, Liza Mae"

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People never excuse when we miss the point

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People always remember when we hit the nail on the head

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Thank You