Establishing a Supportive Care Register Improves End-of-Life Care ...

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Chronic renal disease · Dialysis · End-of-life care · End-stage ... care register on end-of-life care for patients with advanced CKD. ..... Suffolk, 2009, pp 1–48 .
Clinical Practice: Original Paper Received: October 7, 2014 Accepted after revision: January 6, 2015 Published online: February 18, 2015

Nephron DOI: 10.1159/000371888

Establishing a Supportive Care Register Improves End-of-Life Care for Patients with Advanced Chronic Kidney Disease Jennifer K. Harrison a Laura E. Clipsham b Caroline M. Cooke b Graham Warwick c James O. Burton c, d   

 

 

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Department of Cardiovascular Sciences, University of Leicester, Leicester, b Palliative Care Services, University Hospitals of Leicester NHS Trust, Leicester, c John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, d Department of Infection, Immunity & Inflammation, University of Leicester, Leicester, UK  

 

 

 

Abstract Background: End-of-life care for patients with advanced chronic kidney disease (CKD) is recognised as an important area for improvement. These patients have a significant mortality and, although some is unpredictable, there is a role for the nephrology multi-disciplinary team (MDT) and palliative care physicians to engage in advance care planning and support patients to discuss their preferences. Methods: Retrospective and prospective data were obtained to conduct a comparison observational study to assess the impact of introducing a supportive care register on the end-of-life care for patients with advanced CKD. An electronic supportive care register was implemented. This required a programme of multi-disciplinary staff education, collaborative working with Palliative Care to establish renal-specific protocols and dissemination activities. The impact of the intervention was assessed by analysing all deaths in two six-month periods where all those with an eGFR