Research suggests that there is an urgent need for a clearer understanding of the risks and causes of harm for out-of-hours palliative care.
In a study funded by terminal illness charity, Marie Curie, and the Scientific Foundation Board of Royal College of General Practitioners, researchers at the Cardiff University reviewed 1072 patients receiving palliative care. The findings revealed that 64.8% of the patient safety incidents were indicative of ‘actual harm’ to patients, including emotional and psychological distress to patients, families and carers. These incidents included medication errors associated with prescribing, dispensing or administration or delayed access to care or advice. Incidents of serious harm such as hospital admission and untimely death were seen in 12% of the patients receiving palliative care, most of them being medication-related.
Overall 4 key areas of improvement were determined:
- Medication provision errors,
- Gaining access to timely care,
- Inefficient communication between health care teams and
- Issues with non-drug interventions such as urinary catheters and feeding tubes.
The challenge with palliative care is that much of resources are directed towards in-hours services, with limited staff, services and funding dedicated to out-of-hours care. Simon Jones, Director of Policy and Public Affairs at Marie Curie, said: "More focus needs to be placed on what care and support is available out of hours, so people can access the right care they need at home to avoid unnecessary hospital
