A review of end of life medication administration by ambulance clinicians
Mackinnon, Scott Fickling, Keri Laird, Caitlin Johnston, Robert Campbell, Sandra
Mackinnon, Scott
Fickling, Keri
Laird, Caitlin
Johnston, Robert
Campbell, Sandra
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Abstract
Abstract
Introduction Historically, paramedics have focused on life-saving and curative Care. Today a growing body of evidence suggests many patients seek support from the ambulance service for Palliative and end of life (EOL)care. This has resulted in ambulance services globally embracing new paradigms of care, including Palliative care.
Scottish Ambulance Service (SAS) have partnered with Macmillan to form an EOL care team to drive forward education and pathways for EOL patients, because in Scotland around 95% of people in the last year of life contact unscheduled care services. One of the main requirements of theses contacts is symptom relief.
This project looks at the use of JIC and other EOL medication administrations by SAS clinicians.
Aims To monitor and report on EOL medication use by SAS clinicians and the usage both prior to and during the Macmillan project to identify the efficacy of education and impact upon practice.
Method By retrospectively reviewing the patient report forms the team were able to audit each administration of EOL medications.
Determining;
If the medication administered was the patient‘s own or SAS stock,
The type of medication administered,
The impact the medication had for the patient
If the patient was conveyed to hospital.
Results The results showed, since the implementation of the Macmillan project;
The use of EOL medication has increased.
The range of medications given by clinicians is broader.
The median administration has increase from 6 to 12
Conclusion We believe the introduction of the Macmillan team and the education they have been delivering to clinicians across the country is supporting the increase in EOL medication administrations within SAS.
Impact Improved patient care at the EOL, quicker symptom relief, supporting patients at the right time with the right care, in the right place.
References
Collier A, et al. “‘The palliative care ambulance’: A qualitative study of patient and caregiver perspectives of an ambulance service.” Palliative Medicine 2023;37(6):875–883.
Murphy-Jones G, et al. “Infusing the palliative into paramedicine: Inter-professional collaboration to improve the end of life care response of UK ambulance services.” Progress in Palliative Care 2021;29(2):66–71.
Juhrmann ML, et al. “Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis.” Palliative Medicine 2022;36(3):405–421.
Mason B, et al. “Integrating lived experiences of out-of-hours health services for people with palliative and end-of-life care needs with national datasets for people dying in Scotland in 2016: A mixed methods, multi-stage design.” Palliative Medicine 2022;36(3):478–488.
https://spcare.bmj.com/content/14/Suppl_1/A17.2
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