LIVERPOOL CARE PATHWAY

Liverpool Care Pathway

Introduction3

Literature Review3

Methodology5

Qualitative Research method6

Interviews and questionnaires7

Reliability and Validity / Credibility and trustworthiness9

Findings9

Evaluation10

References13

Appendix17

Consent Form for Participation in a Research Study17

Liverpool Care Pathway

Introduction

My chosen topic is the Liverpool Care Pathway. Ive chosen this topic, due to working in the NHS as a Healthcare Assistant and to find out what other people views are on this topic.

Over the last few decades advances in burn care and intensive care medicine have led to improvements in survival following burn injury. Despite this there are still patients in whom the ultimate outcome will be death. Some non survivors may be obvious from the outset. In others however, a decision of futility needs to be made during the course of treatment when it becomes apparent that despite best efforts the patient fails to respond to treatment.

The importance of improving end of life care has been recognized by the Department of Health and the General Medical Council. Both have issued guidance aiming to standardize end of life care and improve its delivery. The process of death and the care of the dying patient is potentially highly emotive not only for the patient and their family but also for the health professionals involved in treatment. This can be reduced through the delivery of quality end of life care. Discussions addressing the impending end of life and the potential non response to treatment can be difficult and as a result may be poorly delivered. The perception that death is a result of medical failure is common amongst the medical profession who may fail to see that good end of life care can be a positive experience, particularly for the family of the deceased.

Literature Review

Much of the research into end of life care has been carried out in the hospice setting and concentrates specifically on those dying from end stage metastatic or chronic disease. This has led to an improved understanding of what constitutes a “good death” and the factors that are important in terminal care. In the United Kingdom, this has led to the development of the Liverpool Care Pathway (LCP) which enables hospice type care to be delivered in a non hospice setting. The LCP has been recently modified for use in the acute setting for patients in the last few days of life. Given the improvements seen when the LCP is in use it seems sensible to extend its use to the clinical setting where death may occur rapidly (over a number of hours). It has been successfully modified and used in the accident and emergency setting with positive results .

End of life care in burn injured patients is as important as it is in other settings, consequently we sought to modify the LCP for use in burns. This was introduced at the St Andrew's Centre for Burns in 2007 and was well received by medical and nursing staff. This led to an improved perception of dying in our unit.

In England, the Liverpool Care Pathway for the Dying Patient (LCP) (Ellershaw et ...