1. Preferred Priorities of Care Link Nurse Study Day Judith Wilde & Gerard Kenyon 11 th May 2011

2. Principles of Good Communication Brainstorm ?

3. Principles of Good Communication Body Language Non-verbal Communication Listening Using Open Focused Questions Communication Barriers for Patients Communication Barriers for Staff Tips for good communication

4. NQAT Element: EnvironmentSource When a patient dies staff are aware of the information that needs to be given.Ask staff Observe documentation There is an identified area for use by relatives if privacy is required.Ask staff Element: Care Patients’ cultural and religious beliefs should be documented within 24 on admissionObserve documentation Staff are aware of when to use the Liverpool Care Pathway – document is completed accurately. Ask staff Observe the pathways Staff have documented interaction with patient and significant other regarding preferred plan of care. Observe documentation. Registered staff are assessed and signed off as competent to use the subcutaneous infusion pump in palliative / end of life care Training records Staff are aware of where to locate the clinical guidelines for use of the Graseby MS26 infusion pump – and the 24 hour subcutaneous infusion record Ask staff to demonstrate Ask to see document Staff are aware how to access 24hour palliative care advice either from the hospital palliative care team or from the local hospice (out of hours). Ask staff Staff are aware of where to seek advice on artificial nutrition and / or hydration in End of Life Care Ask staff DNAR decision is documented as discussed with patient and family/significant other.Observe documentation Staff are aware of the End of Life Strategy.Ask staff Staff are aware of the process in relation to a patient having an Advance Decision to refuse treatment in place Ask staff

5. EOL Group presentation9.1Establish systems and processes to ensure End of Life quality outcomes are met. 9.2To develop a Trust End of Life Strategy which is in line with the strategies of Cumbria and North Lancashire PCT’s and monitor the implementation. 9.3To monitor the implementation of relevant NICE or other significant national guidance within EoL Care. 9.1Establish systems and processes to ensure End of Life quality outcomes are met.9.2To develop a Trust End of Life Strategy which is in line with the strategies of Cumbria and North Lancashire PCT’s and monitor the implementation.9.3To monitor the implementation of relevant NICE or other significant national guidance within EoL Care.

6. Aspects of Advance Care Planning Opening the conversation Explore the options Identify your wishes & preferences Refusing specific treatment, if you wish to Ask someone to speak for you Appoint someone to make decisions for you using a Lasting Power of Attorney Let people know your wishes

7. ‘The route to success’ in end of life care – achieving quality in care homes Influenced by ‘End of Life Care Strategy’ 2008

8. Checklist Who is the PPC document for? What is the PPC document for? Should other people be told about a patient’s PPC? Will preferences & priorities be met? What should be included in a PPC? How do you obtain a PPC document?