PUSAT PERUBATAN UNIVERSITI MALAYA (UNIVERSITY MALAYA MEDICAL CENTRE)

Transcription

1 NAMA DOKUMEN: (DOCUMENT TITLE) NOMBOR DOKUMEN: (DOCUMENT NUMBER) DEATH MANAGEMENT POLICY AND PROCEDURES MUKA KULIT (COVER PAGE) TARIKH KELULUSAN : (APPROVAL DATE) TARIKH BERKUATKUASA : (EFFECTIVE DATE) TARIKH KAJISEMULA : (REVISION DATE) PENULIS DOKUMEN : (DOCUMENT S WRITER) ASSOC. PROF. DR. MOHD IDZWAN BIN ZAKARIA DR. RUSINAHAYATI BT MOKHTARUDIN DISEMAK OLEH : (CHECK BY) HOSPITAL POLICY COMMITTEE DILULUSKAN OLEH : (APPROVAL BY) UMMC BOARD OF MANAGEMENT DISAHKAN OLEH SETIAUSAHA LEMBAGA PENGURUS, PPUM : (VERIFICATION BY SECRETARY, BOARD OF MANAGEMENT, UMMC) (ISKANDAR BIN AHMAD) DOKUMEN INI ADALAH HAK MILIK SEPENUHNYA PUSAT PERUBATAN UNIVERSITI MALAYA (PPUM). SEBARANG SALINAN SEBAHAGIAN ATAU SELURUHNYA DOKUMEN INI TIDAK DIBENARKAN SAMA SEKALI KECUALI MENDAPAT KEBENARAN SECARA BERTULIS DARI BAHAGIAN PENGURUSAN KUALITI, JABATAN KUALITI, PUSAT PERUBATAN UNIVERSITI MALAYA. THIS DOCUMENT BELONGS TO UNIVERSITY MALAYA MEDICAL CENTRE (UMMC). ANY DUPLICATION PARTIALLY OR FULLY IS PROHIBITED EXCEPT WITH WRITTEN CONSENT FROM QUALITY MANAGEMENT DIVISION, QUALITY DEPARTMENT, UNIVERSITY MALAYA MEDICAL CENTRE.

2 2 / 5 1. PURPOSE Death Management Policy and Procedures is designed to ensure the deceased and their family is kept at the focus of care with their privacy and dignity maintained with proper care of disposition and handling of the body including accurate and complete documentation and record. 2. SCOPE The Death Management Policy and Procedures is applicable to all healthcare providers and hospital staff. Death Management Policy and Procedures include pre-hospital death, brought in death, death at Emergency Department, hospital death, potential medico-legal and medico-legal death. 3. DEFINITION 3.1 Pre-hospital death Victims found to have died during pre hospital care service. 3.2 Brought In Dead (BID) All cases admitted to the Emergency Department with no sign of life. 3.3 Death In Department (DID) All cases admitted to the Emergency Department with sign of life and later died in Emergency Department. 3.4 Hospital death: Any death of a registered patient in hospital not due to medico-legal case. 3.5 Potential medico-legal is death where the cause of death is uncertain which includes : o Death within 24 hours of admission without establishment of diagnosis o Death after anesthesia or within 24 hours after surgery o Sudden death where the cause of death is uncertain

3 3 / Medico-legal death is defined as death where the police has issued a P61 form (based on Section 329 and 330 of the Criminal Procedure Code) that includes death from: o Industrial accident or related diseases o Suicide o Criminal or suspected criminal deaths such as gunshot, fire arm injuries o rape, sexual offences/ o abuse, poison, suffocation and drowning. o motor vehicle accident Fall from height, Electrocution/electrical injuries, Lightening Chemical injuries Burns Alcohol intoxication Criminal abortions Animal bite Drug overdose o Death during police custody o Sudden death where the cause of death is suspicious of criminal act. o Sudden death where the cause of death is uncertain o Death In Emergency Department without establishment of diagnosis 4. POLICY STATEMENTS All death in the hospital shall be verified by Registered Medical Practitioners. Hospital death certificate and burial permit shall be signed and stamped by registered Medical Practitioners. The management of death shall be in accordance with AK-7.5-NUR- 002,003,004, Arahan Kerja Pengendalian Kes Kematian and PK-7.5-NUR- 005 Presedur Kerja Pengurusan Kematian Pesakit. The next of kin should be informed of the death by any member of the multidisciplinary team, who attended the patient. Unless prior arrangements have been made with the next of kin, every attempt should be made to contact them at the earliest opportunity and within one hour of death. This may involve asking for the assistance of external agencies such as the Police.

4 4 / 5 The support needs of the bereaved following the death will be assessed by the Nurse responsible for the patient s care. In the case of a death where organs (including tissue and corneas) may be suitable for donation please refer to UMMC Organ & Tissue Donation Policy. Personal care after death is the responsibility of the registered nurse. The deceased patient should be prepared for a dignified transfer to the hospital mortuary with due regard to religious and cultural needs. Post Mortem Requests can be done following Hospital/Clinical Post Mortem or Medico-legal Post-mortem (P61 Order) Medico-legal Post Mortem (P61 Order) In cases under medico legal death, medical staff are required to inform the Police. The police has the right to order a post mortem without next of kin consent using the P61 form. The detail of the management of potential medico-legal and medicolegal death and post mortem to be refer to AK-7.5-NUR-002,003,004, Pengendalian Kes Kematian Pesakit. Hospital Post Mortem/Clinical Post Mortem If there are no grounds for P61 from the police, a postmortem examination may be requested on the grounds of clinical interest (a so-called Hospital or permission autopsy). A hospital post mortem can only be performed if the next of kin/legal guardian/responsible family member give informed consent by signing form BK- MIS-13 The doctor must not use the threat of notifying the police as means of obtaining permission for a hospital autopsy from a reluctant relative. Where a hospital post mortem is required, medical staff with a nurse acting as an advocate for the family, present, should raise the issue of a post mortem with the next of kin/legal guardian/responsible family member. This meeting will include a discussion about the nature of a Post Mortem. Specific consent must be taken for: i) The removal ii) The retention of organs and tissue

5 5 / 5 The consent form can be signed if the next of kin are willing; however they can have up to 24 hours to decide before signing the consent form if they wish. Consideration should be given to post mortems in which only one area of the body is examined. This should be discussed with the next of kin by a doctor. The next of kin shall sign refusal of Post Mortem form BK-MIS-131 if they refuse hospital post mortem. The consequences of refusal of post mortem are informed to the next of kin. 1. It is not possible to establish the cause of death 2. Civil or other claims (including insurance claims) instituted by the Administrators of the estate of deceased may be impeded. The doctor shall write the probable cause of death or unknown in the Medical Cause of Death Certificate (MCOD) and burial permit if the cause of death is uncertain and the next of kin/family refuse hospital post mortem. If in doubt, the medical staff shall seek advice from legal unit/police. 5. RELATED DOCUMENTS 5.1 PK-7.5-NUR-005 Prosedur Kerja Pengurusan Kematian Pesakit. 5.2 AK-7.5-NUR-002,003,004, Arahan Kerja Pengendalian Kes Kematian Pengendalian Kes Kematian Pesakit 5.3 AK-7.5-EME Arahan Kerja Penerimaan Mayat Brougth in Dead (BID) 6. REFERENCES 6.1 Penal Codes 6.2 Code of Professional Conduct MMC 6.3 Medical Act 1971