Wednesday, 6 February 2013

Liverpool Care Pathway - On The Road To Dundee

The DCP is an EoL tool developed in consort with the University of Dundee. No, this is not the Dundee care Pathway; it is the Dignity Care Pathway.

Dignity in End-of-Life Care

"All the evidence suggests that the DCP has proved to be a crucial tool for nurses to help them bring out sensitive issues."

"Nurses identified that using the DCP allowed them to reconsider which patients required palliative care.  In line with Scottish Government (Scottish Government 2008) policy, this study encouraged nurses to consider approaching any patient who the nurse considered was in the last months of their illness, regardless of diagnosis, and including the frail elderly."
[PAGE 12 - QNIS Project Report]

"...the nurse knew the PDI contained several questions that could “‘stir up a lot of things”. On the other hand, by letting the patient fill in the PDI themselves and then come back to discuss it allowed the control to be handed to the patient." 

The Dundee Dignity Care Pathway is a psychometric questionnaire designed to groom the patient into accepting palliative care.

Psychometric tests (see psychological testing) are used both to generate empirical data on mental processes and to refine their understanding of measurement techniques and the statistical analysis of results. Major concerns include test reliability and validity and the norming or standardization of results.

Psychological testing, also called psychometrics, the systematic use of tests to quantify psychophysical
behaviour, abilities, and problems and to make predictions about psychological performance. [Britannica] 

Psychometric testing is also a tool devised by Ron L Hubbard to groom adherents for recruitment to the Church of Scientology.

This is -

Scots develop care pathway

February 4 – Scottish researchers say they have developed a new care pathway to help community nurses work with terminally ill patients in preparing for their last months. The “Dignity Care Pathway” has been launched as a government investigation gets under way into the Liverpool Care Pathway. The Liverpool pathway faced criticism amid complaints from families that they did not understand what was proposed – especially when treatment was withdrawn. Researchers at Dundee University say their system provides support to the nurse and to the patient.
Researcher Dr Bridget Johnston, a nursing lecturer, said the system would enable highly personalised care.
She said: “This is a time of life where patients can have very different concerns and needs and where a trusting, constructive relationship with the community nurse can be both a comfort and a help.
“The system helps build a pathway of very personalised care, catering to the concerns and needs of each particular patient.
“It can also help build a strong relationship between nurse and patient, which our research has shown to be very important in this area of palliative care.”
Dr Deans Buchanan, a consultant in palliative medicine at NHS Tayside, said the new pathway provided a “safe, structured” approach.
He said: “This tool also gives a framework to aid the confidence of the professional to know how to respond in a compassionate, evidenced and effective way to such issues.
“Our experience in this study has re-enforced the usefulness of the tool as a gateway to such conversations occurring and was welcomed and acceptable to patients.”
Source: Englemed

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