Nursing times
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A team of palliative care clinical nurse specialists at the Phyllis Tuckwell Hospice in Farnham, Surrey, set up a hospice based outpatient clinic to improve services for patients with cancer. This article examines how the team used clinical audit, a staff questionnaire and patient feedback to evaluate the service and make recommendations for the future development of the clinic.
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Diabetes services in Milton Keynes were being duplicated and a need to coordinate services in local primary care settings was identified. This article explores how nurse led clinical commissioning is improving services for patients with diabetes in the area. It examines the practical challenges of the service redesign, how personalised care planning for people with diabetes can improve quality of care, and the benefits for nurses of becoming involved in clinical commissioning.
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Around half of the 500,000 deaths in England each year occur in acute hospitals, while around half of all complaints made to acute trusts relate to an aspect of end of life care. Howaver, research suggest that 40% of people who die in hospital have no medical need to be there, and that 55% of people with cancer would prefer to die at home while only around 25% do so. When people die in hospital despite having a preference to die at home and no medical reason to be in hospital, it causes unnecessary distress to patients and their familes, and is costly to the NHS. This article, the seventh in our series on the high impact actions for nursing and midwifery, looks at how nurses can help to improve end of life care.
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Dying in a place of one's choice is considered to be a quantifiable measure of the effectiveness of end of life services in primary care. Although most people say they would prefer to die in their own home, very few actually do so. ⋯ These helped practitioners in supporting adults with terminal illnesses to die in a place of their choice. A subsequent audit of patients' actual place of death against their preferred place demonstrates how working in more integrated ways has helped.