Clinical Staff Overview

Clinical Staff Overview

RESOURCES Developed by VEC Expert reference and consumer group input Last days and hours of life focus State-wide relevance acute and sub-acute care settings

CARE PLAN KEY BENEFITS A tool designed specifically for Victorian healthcare and legislative requirements Meets Australian 1 and International Quality Standards 2 Relevant to the acute and sub-acute care settings Resuscitation and CODE BLUE/MET call planning Organ/Tissue/Corneal donation Generalist focussed +/-SPCS involvement Bereavement risk assessment Recognition of the emotional work -staff support Evidence of care planning and delivery and it s effectiveness is collated in one document 1 Australian Commission on Safety and Quality in Health Care. National Consensus Statement: essential elements for safety and high-quality end-of-life care. Sydney: ACSQHC, 2015. 2 The 10 Core Principles for Best Care for the Dying Person: International Collaborative for Best Care for the Dying Person 2014

OVERVIEW Front pages : Health Professional Guidance Section 1: Recognising Dying - Authorisation to commence - Legal and relevant decision making Section 2: Medical Review of Care Needs Section 3: Planning Individualised Care - Psychosocial care interventions Section 4: Delivery of Care - 4.1 Ongoing Assessment - 4.2 Further Care Action Report - 4.3 Integrated Progress Notes Section 5: Care After Death Section 6: Care Plan Discontinued

GUIDANCE SECTION Guiding principles, governance and definitions Recognising dying communicate, involve and support create an individualised plan with ongoing medical review review The aim of the is to guide and enable health professionals to deliver individualised care to a dying person and those identified as important to them during the last days and hours of life. Individual Health Service organisational policies and procedures should be consulted and adhered to when developing an individualised Care Plan and documenting care delivered. As with all care plans, the information in this Care Plan aims to support but does not replace clinical judgement.

SECTION 1: RECOGNISING DYING MEDICAL STAFF Recognising dying Resuscitation planning Code Blue/MET call planning Authorisation senior Doctor agreement MDT delegates Verbal authorisation Legal/Decision Assisting Info Advance Care Planning Power of Attorney/Guardianship Organ/tissue/corneal donation Coronial death etc Communication Dying person/family agreement Wider healthcare team

SECTION 2: MEDICAL REVIEW OF CARE NEEDS MEDICAL STAFF Initial Assessment Medication Management Common EOL symptom assessment Anticipatory prescribing Algorithms Assess current interventions & discontinue non-essentials Does the dying person require a Specialist Palliative Care referral?

SECTION 3: PLANNING INDIVIDUALISED CARE PSYCHOSOCIAL RELEVANT MDT STAFF 3.1 Brochures Care Plan Family Member/Friend information brochure (mandatory) Facility Other relevant bereavement, Centrelink, etc 3.2 Contact Information 3.3 Funeral Arrangements 3.4 Person-Centred Communication 3.5 Communication with the Dying Person 3.6 Communication with Relative/Friend(s) 3.7 Bereavement Risk assessment/identification (organisational specific) 3.8 Allied Health/Support Services Required Check clinical record for currency of existing information such as who and when to contact and funeral arrangements

SECTION 4: DELIVERY OF CARE 4.1 ONGOING ASSESSMENT NURSING AND MDT MDT daily review Is the person imminently dying? Care Plan Discontinued Record the decision that this Care Plan should be discontinued. Record Date and Time. Complete Section 6: Care Plan Discontinuedand attach to the FRONT of this Care Plan and file. Minimum documentation is 4 hourly. Psychosocial care should be documented at least once per shift

4.1 ONGOING ASSESSMENT NURSING AND MDT A Assessed and no action required F/A Further action required R/C Routine care N/A Not applicable

4.2 FURTHER CARE ACTION REPORT NURSING AND MDT

4.3 INTEGRATED PROGRESS NOTES MDT

SECTION 5: CARE AFTER DEATH MEDICAL AND MDT Verification of Death signature(s) Clinical assessment required to verify death Caring for the deceased Notifying relative/ friend(s) Communication Staff Support Brain Death & Organ Donation

SECTION 6: CARE PLAN DISCONTINUED MEDICAL AND MDT Senior treating Doctor signature Reason(s) WHY Care Plan discontinued Review of Resuscitation Status and CODE BLUE/ MET call Care Planning discussions held with Is a Specialist Palliative Care Service referral required?

KEY MESSAGES Only for use during the last days of life MDT decision in consultation with the dying person/relative/friends to commence Care Plan Care Plan reviewed daily and individualised to the needs of the dying person/relative/friends If the person is not imminently dying, the Care Plan should be discontinued and a new plan of care developed Complete F/As as they occur, not at the end of the shift No need to duplicate information in the health information/clinical record

REQUIRED CITATION You are welcome to use and adapt the material in this Power Point slides. However, in doing so, you mustinclude the following acknowledgement: Content adapted from the VEC VECTraining Power Point training material developed by the Victorian End-of of-life Care Coordinating Program (2016)