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Renal failure and specialist palliative care: an assessment of current referral practice.

Abstract

AIMS

This retrospective audit assessed the referral practice for patients with end-stage renal failure from the nephrology service to the specialist palliative care team in a large teaching hospital in the north-west of England.

METHODS

Forty-nine referrals with 'renal' as a primary diagnosis over a two-year period were identified from referral data. General and palliative care notes were reviewed and a data collection tool was designed.

RESULTS

Most common reasons for referral were for 'placement' (38.6%) and 'dying/distressed' patients (22.7%), although psychological support was also prevalent (15.9%). Renal teams discussed stopping dialysis in the majority of cases (89%), but documented preferred place of care less frequently (48.3%) and achieved discharge to these locations in less than half of cases (21.4%).

CONCLUSION

There was well-established referral practice between the renal and the specialist palliative care team at the hospital examined. The renal team appropriately referred for symptom control and support in the dying phase of patients. There are issues surrounding placement and increased implementation of end-of-life care tools, including the Liverpool Care Pathway, Gold Standards Framework and Preferred Place of Care documentation for renal patients, which needs to be an ongoing priority.

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  • Authors+Show Affiliations

    ,

    Nephrology, Marie Curie Palliative Care Institute, Liverpool, UK. amckeown@nhs.net

    , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    England
    Female
    Humans
    Male
    Middle Aged
    Palliative Care
    Referral and Consultation
    Renal Insufficiency
    Retrospective Studies

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    19060797

    Citation

    TY - JOUR T1 - Renal failure and specialist palliative care: an assessment of current referral practice. AU - McKeown,Alistair, AU - Agar,Ruth, AU - Gambles,Maureen, AU - Ellershaw,John E, AU - Hugel,Heino, PY - 2008/12/9/pubmed PY - 2009/2/12/medline PY - 2008/12/9/entrez SP - 454 EP - 8 JF - International journal of palliative nursing JO - Int J Palliat Nurs VL - 14 IS - 9 N2 - AIMS: This retrospective audit assessed the referral practice for patients with end-stage renal failure from the nephrology service to the specialist palliative care team in a large teaching hospital in the north-west of England. METHODS: Forty-nine referrals with 'renal' as a primary diagnosis over a two-year period were identified from referral data. General and palliative care notes were reviewed and a data collection tool was designed. RESULTS: Most common reasons for referral were for 'placement' (38.6%) and 'dying/distressed' patients (22.7%), although psychological support was also prevalent (15.9%). Renal teams discussed stopping dialysis in the majority of cases (89%), but documented preferred place of care less frequently (48.3%) and achieved discharge to these locations in less than half of cases (21.4%). CONCLUSION: There was well-established referral practice between the renal and the specialist palliative care team at the hospital examined. The renal team appropriately referred for symptom control and support in the dying phase of patients. There are issues surrounding placement and increased implementation of end-of-life care tools, including the Liverpool Care Pathway, Gold Standards Framework and Preferred Place of Care documentation for renal patients, which needs to be an ongoing priority. SN - 1357-6321 UR - https://www.unboundmedicine.com/medline/citation/19060797/Renal_failure_and_specialist_palliative_care:_an_assessment_of_current_referral_practice_ L2 - http://www.magonlinelibrary.com/doi/full/10.12968/ijpn.2008.14.9.31126?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed ER -