title: Caring for people who are dying on renal wards: a retrospective study.
abstract: Unfortunately, there is still a high mortality rate among patients with end-stage renal disease (ESRD). If the decision is made to activate non-dialytic management of the patient with ESRD, it should be made jointly by the patient and responsible consultant nephrologist after consultation with relatives, the family doctor and other relevant members of the caring team. This paper discusses the establishment of a new renal supportive care service for patients opting not to have dialysis and focuses on the results of a 'death audit' carried out on this patient population. Recommendations for practice resulting from analysis of the audit results include, the use of advance directives, identification and prompt treatment of symptoms, increased staff education, timely referral to the palliative care team and expansion and further integration of the renal supportive care team.
authors.affiliation: Barts and The London NHS Trust, UK. helen.noble@bartsandthelondon.nhs.uk
authors.forename: H
authors.initials: H
authors.lastname: Noble
authors.forename: K
authors.initials: K
authors.lastname: Rees
mesh_terms: D000328:Adult; D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D004645:Empathy; D006301:Health Services Needs and Demand; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000517:prevention & control* / Q000523:psychology; D007902:Length of Stay / Q000706:statistics & numerical data; D008485:Medical Audit; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D010564:Personnel, Hospital / Q000193:education; D015397:Program Evaluation; D012017:Referral and Consultation; D016414:Resuscitation Orders; D012189:Retrospective Studies; D012944:Social Support; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000458:organization & administration*; D028761:Withholding Treatment