• Robert J Webb and Cathy P Shelton.
• Palliative Care Service, Eliza Coffee Memorial Hospital, Florence, Alabama, USA. Electronic address: rjwebb@chgroup.org.
• J Pain Symptom Manage. 2015 Sep 1; 50 (3): 371-4.

ContextEliza Coffee Memorial Hospital is a community hospital with a palliative care unit providing inpatient symptom management and end-of-life care. The palliative care unit provides authorized agent controlled analgesia (AACA).ObjectivesThe objective of this study was to determine if an AACA system improves control of pain and other end-of-life symptoms adequately and if it provides families with satisfactory involvement in the care of their loved ones.MethodsData on demographics, pain assessments, length of stay before and after consult, drugs used, mortality, discharge disposition, and family and staff satisfaction were collected by chart review of all 2013 consultations.ResultsThere was a total of 318 consults in 2013. Of the 118 patients (37% of total) who used the AACA system, 112 (95%) died in hospital; morphine was used by 77% and the others used hydromorphone. Following the patient's death, of the 70 AACA families contacted, 100% were satisfied with the pain/symptom control. Staff also were overwhelmingly pleased with the system.ConclusionAn AACA system has been highly satisfactory for patients, families, and staff, meeting the goals of 1) allowing patients with a terminal condition to die peacefully and 2) enabling families to share in the patients' care, providing them with a more favorable memory at the end of life.Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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