Impact of the Liverpool Care Pathway on quality end‐of‐ care in residential care homes and home care—Nurses’ perceptions

Olsson, Cecilia; Kling, Elisabeth; Persson, Karina Grundel; Larsson, Maria

doi:10.1002/nop2.364

Cited by 1 publication

(3 citation statements)

References 37 publications

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“…Although several studies show no clear evidence regarding effectiveness of the use and outcome of the LCP [27,28], many respondents agreed on the helpful structure to improve communication. This is in line with the findings from earlier studies in nursing home settings [11][12][13]15]. Interestingly, while these studies also point to possible improvements in symptom management, not one respondent in our study mentioned results related to earlier or better symptom control.…”

Section: Discussionsupporting

confidence: 93%

“…Medical School Graduate n (%) 18 (11) Nurse practitioner n (%) 29 (18) Of whom in training 2 Missing = 6 organizations *c e.g. Huntington dis., Parkinson dis., acquired brain injury, short stay things symptomatically and we just, when a person gets sick then things go wrong.…”

Section: Interviewsmentioning

confidence: 99%

“…In the literature divergent experiences have been described, ranging from positive experiences of care professionals and relatives regarding involvement in end-of-life care to criticism based on findings that indicate that the LCP is not adapted for certain groups, such as persons living in nursing homes and people with dementia [ 10 , 11 ]. Research into validity and reliability of the assessments in the nursing home setting is limited.…”

Section: Introductionmentioning

confidence: 99%

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Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians’ and nurse practitioners’ perceptions

et al. 2020

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Background The Liverpool care pathway for the dying patient (LCP) is a multidisciplinary tool developed for the dying phase for use in palliative care settings. The literature reports divergent experiences with its application in a nursing home setting related to its implementation and staff competencies. The aim of this study is to understand how the LCP is being used in the context of the nursing home, including for residents with dementia, and experienced from the perspectives of those responsible for medical treatment in nursing homes. Methods A mixed-methods approach was used, consisting of a survey followed by interviews. A link to a 9-item online survey with closed and open-ended questions was emailed to all physicians and nurse practitioners of 33 care organisations with nursing homes in three regions of the Netherlands (North, West and South). In addition, 10 respondents with particularly positive or negative experiences were selected for semi-structured interviews. Results The survey was completed by 159 physicians and nurse practitioners. The respondents were very positive on the content and less positive on the use of the LCP, although they reported difficulties identifying the right time to start the LCP, especially in case of dementia. Also using the LCP was more complicated after the implementation of the electronic health record. The LCP was judged to be a marker of quality for the assessment of symptoms in the dying phase and communication with relatives. Conclusion An instrument that prompts regular assessment of a dying person was perceived by those responsible for (medical) care to contribute to good care. As such, the LCP was valued, but there was a clear need to start it earlier than in the last days or hours of life, a need for a shorter version, and for integration of the LCP in the electronic health record. Regular assessments with an instrument that focusses on quality of care and good symptom control can improve palliative care for nursing home residents with and without dementia.

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