Comprehensive Palliative Care Framework and COVID-19 Admission Decision Pathway
This content provides detailed information on a Palliative Care Framework and a COVID-19 Admission Decision Pathway, covering care plans, support for vulnerable patients, decision-making processes, treatment options, and community palliative care during COVID-19. It outlines steps for patient care in different settings, including community hospitals, care homes, and hospices, emphasizing the importance of patient wishes, symptom management, and collaborative decision-making among healthcare professionals.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
COVID - Admission Decision Pathway Community hospital O Beds medical and nursing Step up/down beds Vulnerable Patients: COVID CATEGORY 1 Care Plans for patients on NHS England vulnerable patients list completed prior to contracting Covid Community Hospital Supportive treatment Step up/down beds Acute Hospital Levels 1-4: ITU O Plus O Beds Step down beds Share care plans on Summary Care Record and CHIE to be available to all duty doctors Record chronic frailty score see NICE Covid guideline 159 Care Homes CATEGORY 2 HIGH RISK condition deteriorating Supportive treatment/nursing care Step up/down beds record patients wishes Use ReSPECT/future planning template Possible New Community Sites Supportive treatment nursing and care Step up/down beds Decision to admit process: (If care plan does not confirm patient wishes to stay at home) Patient s Home Patients wishes to be at home Family able to be present Supportive treatment(palliative) Decision Point 1 - Duty Doctor to discuss with patient taking into account deterioration of symptoms and comorbidities Decision Point 2: discuss with a second GP. Preferably patients own GP to review patients wishes against deterioration in symptoms Consideration for stepping up/down: Respiratory Rate Saturated O2 Levels Temperature Heart rate NEWS2 increasing/decreasing comorbidities Decision Point 3: discuss with MAU consultant to decide appropriate setting based on patients wishes, NEWS2, frailty score and comorbidities
Community Palliative Care During Covid Cat 1 from 111 or practice Care plan states not for escalation Patient in own home/residential care ONE TEAM response SPA Home Visiting /remote support GP Community Team Palliative Care advice or outreach Practice Nurses Paramedics OOH Agree supportive treatment plan with patient and family Safety of family/carers PPE Social Distancing Escalation Requested from plan MAU discussion which agrees care and support for patient Non-Covid Palliative Care Patient In community hospital/ other facility Discharge with TEP For End of life support Further palliative care May be suitable for readmission Hospice Care Methods of administration Risks Anticipatory meds Care needs consider speed of deterioration and who is available to deliver Oral or sublingual Syringe driver Sub cutaneous Transdermal rectal Mental wellbeing for team and family Equipment Physical support Oxygen if available Anticipatory medicine guidelines Capacity and resilience Availability of workforce to deliver care Availability of syringe drivers PPE access to patient records for all professionals Breathlessness Agitated delirium and anxiety temperature Secretions Cough
