Contacts
Contact:
Diane Laverty
Lead NurseBereavement Services
Organisation:
The Royal Free Hampstead NHS Trust
Pond Street London NW3 2QG United Kingdom
Tel:
020 7794 0500
020 7830 2863 (direct)
Email:
Case study:
11 May 2010
Care of the deceased: multidisciplinary guidelines in the Royal Free Hampstead Trust
Key points
- The Royal Free Hampstead Trust has introduced new multidisciplinary guidelines to improve bereavement care
- The guidelines are designed to give clarity to procedures after death and ensure relatives receive timely, appropriate information
- Two new forms have been introduced – an infection control form and a last offices checklist
- Results of an evaluation of standards of practice and clinical incidents are expected shortly.
The Royal Free Hampstead Trust has produced new multidisciplinary guidelines to improve care immediately after death and ensure relatives receive appropriate, timely information following their bereavement.
The move came after a survey of local agencies revealed unsatisfactory practice in caring for bodies after death.
There was also some confusion about staff responsibilities.
In addition, staff were concerned about delays in issuing death certificates because medical staff gave them insufficient priority.
Moreover, no structure existed for referring problems to the appropriate source.
As a result of the changes two new forms have been introduced – an infection control form that requires staff to note if a significant infectious disease is present after death and a last offices checklist to ensure all aspects of good care are covered immediately after death.
The guidelines are multidisciplinary, underlining the fact that death and bereavement are everybody’s concern and responsibility for an individual does not end until the body is released from the mortuary to the undertaker.
A comprehensive teaching plan has been instigated to cover all professionals.
This was recently extended to all new staff.
It is also a standard part of all induction programmes for doctors and nurses.
A senior lead nurse has overseen the guidelines’ introduction and run the teaching programme.
She was also responsible for introducing new and updated operational activities for the bereavement office.
In addition a new part-time assistant bereavement officer post has been created and an appointment made.
Three months after the guidelines were launched a further questionnaire was sent out to funeral directors to check whether standards of practice had improved.
Results are expected soon.
A cumulative review has also been requested of all clinical incident reports completed in the first three months after the launch of the new guidelines.
The initiative requires every member of staff to give priority to the bereaved.
It has to be said that some departments had to be consistently challenged to make meaningful changes in practice.
An efficient and responsive bereavement service is seen as integral to the development of the trust’s end of life strategy.
Initially managed by support services, the bereavement office is now overseen by the Macmillan nurse consultant in palliative care, which provides a more clinically-focused structure.
The success of the guidelines will be monitored at regular intervals but there will also be a formal review within the next four years.
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