看取りのクリティカルパスの作成と導入

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タイトル別名
  • The development and introducing critical pathway for the dying patient
  • ミトリ ノ クリティカルパス ノ サクセイ ト ドウニュウ

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The development of a critical pathway based on evidence and appropriate guidelines promotes improving the quality of life of patients and their families facing the problem associated with life-threatening illness. In a few weeks before death, it is important that palliative care staff may be working under the consensus of policy to deliver active and appropriate care and to avoid giving conflicting message to the family. Our critical pathway use the criteria to diagnosis for dying based on evidences identified by AHCPR classification type la to 3 and deceased 489-inpatient record analysis. There are two steps in our critical pathway. First compone nt mainly focuses the preparation to form comfortable hospital days for good death including discontinuing inappropriate interventions and non-essential medication according to agreed guidelines, re-planning of nursi ng care and reconfirmation of family view with their informed consent. Second step is ongoing care to dissol v e the problem to be suffered the patients from pain, dyspnea, respiratory secretion, vomiting, bowel distenti on, dry mouth, sleeplessness, confusion, anxiety and grief of their families and so on. In conclusion critical pa thway for dying patient have proven to reduce cost and hesitation of staff to cure or to care. In next setting we would determine and analyze variances.

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