All-Wales integrated care pathway project for care homes: completing the audit cycle – retrospective baseline audit findings of documented care during the last days of life of residents who died in care homes and the re-audit findings following implementation of the ICP

Abstract

ABSTRACT

In 2005, the south-east Wales Cancer Network obtained support from Macmillan to fund a coordinator for a three-year project to improve the care that dying patients receive in care homes (nursing) across south-east Wales by the implementation of the integrated care pathway (ICP) for care in the last days of life.From the project outset it was clear that to gain commitment to the project from the care home senior staff they needed evidence that the ICP would improve the care they delivered to patients at the end of life. This was obtained through undertaking a retrospective baseline audit examining the documentation of care provided for dying patients in care homes, implementing any changes required and then re-auditing to review improvements.From the evidence and recommendations, changes were implemented including ongoing education for all levels of care home staff. The audit was repeated one year later to measure whether these changes had proved to be beneficial.This article provides an overview of the completed audit cycle results whilst outlining the changes that were implemented and highlighting some recommendations for the future. Throughout the article when it refers to a ‘patient’ this also refers to 'residents', ‘service users’ and ‘clients’.