When Someone Dies A Consumer Perspective

Transcription

1 When Someone Dies A Consumer Perspective NetP Programme November 2015 Joy Sixtus, Customer Services

2 What s covered? Nursing responsibilities before and after death Policies, Procedures & Legislation related to care after death Clothing and valuables Access & Viewing When the Coroner & police are involved Family Support & Follow-up

3 DEATHS IN HOSPITAL

4 Hospital deaths some perspective Approximately 1,000 hospital deaths annually Approximately 400 community deaths through Mortuary 8% of hospital deaths are referred to the Coroner No jurisdiction taken in 75% of cases referred A formal inquest hearing likely in only 20% of referred cases (1.5% of all hospital deaths) Of these a significant proportion are for antecedent events, AND only a few relate to treatment received in hospital Therefore for most staff it is unlikely you would ever be called as a witness at a formal inquest.

5 What is a Coroner? Not a pathologist Not a medical examiner A Coroner is a Specialist Judge/Judicial officer Coroners in NZ must have been senior barristers or solicitors Crown appointments

6 Coroners deal with All Suicides All Homicides All Drownings All Aircraft crashes All Motor vehicle crashes All Sudden infant deaths All deaths in prison Some Deaths in Hospitals, Rest Homes and Community deaths

7 Role of Coroner - Deciding Have they died? Who has died? Where they died? When they died? What did they die of? How come they died? Preventing this sort of death happening again

8 Have they died? Pike River Mine Explosion 19 November 2010 Greymouth, 29 declared dead

9 Some deaths must be reported to the Coroner e.g. Where no known cause Violent Unnatural Where death could be due to surgery or a procedure or anaesthetic Where person was under the MHA Where person was in custody

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11 HOMICIDE

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14 Do I remove equipment? No Keep in situ lines, tubes that are in neck,chest, abdomen, urethra, e.g. Urinary and Supra pubic catheters NG PEG, PEJ tubes CVP lines, PICC lines drains Cover leaking wounds with Op Site

15 CLAMP/SPIGOTT tubes for transporting body to mortuary for Post mortem Bags bottles etc go with body, character of contents Cap IV lines and leurs or record amount and No need to keep the giving set unless there may have been a problem with it, or the possibility of incorrect IV having been given ET TUBES - CHECK with Coroner but unlikely need to be kept in situ EXCEPT If chance they have incorrectly placed... Then can be cut down.

16 Clinical notes Need to go with body to mortuary Will be returned Must include charts not normally kept with notes such as fluid balance and TPR charts Organ donation Where deceased is an organ donor Normally organs can still be donated Clinicians talk with Coroner prior to death where organ harvesting is anticipated

17 Clothing & Valuables Clothes - bagged, labelled and go with body to mortuary. These will later be released to next of kin or managed by the appointed Funeral Director. Valuables recorded on the admission sheet, so at the time of death this can be cross-referenced and all items accounted for. Family present at time of death may ask to remove/take valuables home. However, if they are not an executor of the estate, we recommend that these too, accompany the body to the mortuary or for large sums of money or higher value items, then these can be secured in the Hospital safe. This is to ensure that in the dispersement of the deceased s estate, their expressed wished are met.

18 Access & Viewing Family requests to spend time with the deceased in the Mortuary viewing area. - if subject of a trauma or other unexplained event, this will be on Coroner s direction and may only be for the purposes of formal identification under Police supervision. - restricted to Coroner s permission if a post mortem hasn t been carried out. Encourage to engage Funeral Director as soon as possible. Any viewing can best be managed at their premises once deceased properly prepared. May be cultural reasons to be accommodated.

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20 700,000 hospital admissions per year 90,300 adverse events 36,000 potentially preventable 13,500 result in permanent disability or death $162M per annum

21 Coroner s Inquiry - The Coroner will ask for reports and statements from some hospital staff. Statements are requested by the Coroner through the Clinical Director and are to be made in writing. You have a right to seek legal advice before making these. Sometimes an inquest will also be held.

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23 What happens at an inquest? An inquisitorial process: - ensure identity of deceased & cause of death known; - establish when and where the person died; - understand the causes & circumstances of death. Witnesses & experts give evidence or witness statements read; Pathologist's report, and any other findings/papers presented. Witnesses required by law to attend and give evidence Coroner; the immediate family through Coroner or their legal representation; or other person/body corporate may ask questions.

24 Importance of Documentation? Only by documenting all relevant information can you ensure others will know: what you saw what actions you took when actions were taken By not recording details it may be assumed that care did not occur. What you write should accurately reflect the standard of care you gave will your entry stand up to scrutiny? The Clinical record is the only written record which details consecutively exactly what happened through a patient s episode of care and evidence of care and treatment you provided.

25 Health Activities in NZ 1.2 million public hospital discharges per year Health Quality & Safety Commission ( 90,300 adverse events 36,000 potentially preventable 13,500 result in permanent disability or death $162M per annum

26 Questions to consider for family? Think about what happens for the partner, family and whanau once they leave the hospital Value of follow-up telephone calls the ICU model Options for meetings Other agencies involved.

27 Your Questions? From today do you have any questions? Experiences arising from your practice to share? End of Session