Revising a Policy on the Pronouncement of Death Janelle Currie, Rashel Lim and Jennifer Timer Langara College INTRODUCTION
As nursing students we have limited freedom to make a change since we are confined to the role of a student. We are often told to critically think and reflect on situations but we are bound by our Nursing Program’s policies and procedures, making it hard to actually create change. This past semester was the first time we felt that we made a difference on our own. Our job was to change a policy to reflect current evidence based practice BACKGROUND
The project in question was a policy revision on the pronouncement and verification of expected death by a registered nurse (RN), Registered Psychiatric Nurse (RPN) or Licensed Practical Nurse (LPN) at a Hospice known as the Dr. Peter Center Dr. Peter Center is a residence for people living with HIV/AIDS The Dr. Peter Center requires a standard clinical policy to provide guidance for who can legally pronounce expected death Providing clear expectations that the nurse can pronounce the death ultimately benefits the client’s family and connected parties According to Martin Payne, a nurse practioner at Dr. Peter Center, “A nurse being able to pronounce death and provide the necessary closure and care as soon as possible is a great advantage, particularly in our situation where at the Dr. Peter Residence, MDs are rarely around” (2011).
RESEARCH POSTER PRESENTATION DESIGN © 2011
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MATERIALS AND METHODS
Completed a Literature Review Obtained policies about end of life care from all the Health Authorities in the Lower Mainland as well multiple Hospices Created a concept map Organized all our data into a concise guideline that will be easy to read and follow 9 drafts
RESULTS Pronouncement of death is “not a reserved or a delegated medical function” (College of Registered Psychiatric Nurses of British Columbia, 2011) and falls within the scope of the RN, RPN or LPN when death is expected at a Hospice. A new policy with clear guidelines was created, which outlines the steps to take when pronouncing death Improves end of life care at the Dr. Peter Center for patients and their families because of the close relationship between nurses and clients
CONCLUSION
The policy we created is currently being reviewed by the board of directors for full approval before implementation Policies need to be reviewed and revised accordingly specific to the agency Policy revision is a skill that a nursing student can perform
LITERATURE CITED Abbotsford Regional Hospital and Mission Memorial Hospital. (2006). Patient Care Guidelines: Death in acute care, RN/RPN to pronounce (Publication No. PCG-V330). Vancouver, BC: Fraser Health Authority. College of Registered Nurses of British Columbia. (2011). Questions and answers. In Legal issues. Retrieved from https://www.crnbc.ca/Standards/LegalIssues/Pages/Default.aspx. College of Registered Physiatric Nurses of British Columbia. (2011). Practice Guideline: Pronouncement of death. Retrieved from http://www.crpnbc.ca/wpcontent/uploads/2011/02/pronounce_death.pdf. Dr. Peter Center. (n.d.). Providing Palliative Care (Publication No. 10.10.2). Dr. Peter Center. (n.d.). Planning Final Arrangements (Publication No. 10.10.3). Dr. Peter Center. (n.d.). Post Mortem Care (Publication No. 10.11). Leathley, M., Murray, N., & Schoen, B. (2009).Death (Adult): Care of the patient, procedure for (PHC)(Publication No. NCS5086).Vancouver, BC: Provincial Health Care. Ministry of Health. (2006). Joint protocol for expected/planned home deaths in British Columbia. Retrieved from http://www.health.gov.bc.ca/hcc/pdf expected_home_death.pdf . Murray, N. (2010). Pronouncement of expected death in acute/subacute care, procedure for (Publication No. NSC5439). Vancouver, BC: Provincial Health Care. Provincial Health Care. (2010). Infection prevention and control manual: Care of the body after death (Publication No. ICS5049). Vancouver, BC: Author.
ACKNOWLEDGEMENTS AND CONTACT INFORMATION • Martin Payne, Dr. Peter AIDS Foundation • Jennifer Timer, Langara College • Cat Martin, Langara College • Pat Richardson, Providence Health • Gail DiBernardo, Providence Health Care / PHC Research Institute • Susan MacDonald, Langara College • Astrid Westervelt, Providence Health Care For More inforrmation please contact jcurrie00@mylangara.bc.ca or rlim01@mylangara.bc.ca