Artificial nutrition and hydration at the end of life: beneficial or harmful. 2017. (accessed 7 September 2018)

Black F, Caestecker S, Faull C, Nicholosen A. Handbook of palliative care, 3rd edn. London: Wiley & Blackwell; 2013

Cairnduff K, Venkatasalu M, Whiting D. Life after the Liverpool Care Pathway (LCP): a qualitative study of critical care practitioners delivering end-of-life care. J Adv Nurs. 2015; 71:(9)2108-2118

Chan RJ, Webster J, Bowers A. End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database Systemat Rev. 2016; 2

How to ensure the right people, with the right skills, are in the right place at the right time. A guide to nursing, midwifery and care staffing in the care setting. 2014. (accessed 3 June 2018)

Starting end-of-life conversations in hospital. 2015. (accessed 12 February 2018)

Department of Health and Social Care. One chance to get it right. 2014. (accessed 9 January 2019)

Department of Health and Social Care. Our commitment to you for end of life care. 2016. (accessed 25 September 2018)

Dying Matters. Talking about death and dying. 2019. (accessed 25 September 2018)

Nurses lack skills in end of life care. 2010. (accessed 3 March 2018)

Gold Standards Framework. The National Gold Standards Framework in end-of-life care. 2019. (accessed 22 May 2018)

Why it's ok for your loved one to stop eating and drinking on hospice. 2015. (accessed 19 January 2018)

Mauk K. Gerontological nursing: components for care.Mississauga, Canada: Jones and Bartlett Publishers; 2013

Nurse preparation for end of life care is sadly lacking. 2010. (accessed 3 March 2018)

National Institute for Health and Care Excellence. Care of the dying adult in the last days of life. 2017. (accessed 9 January 2019)

Royal College of General Practitioners, Royal College of Nursing. Matters of life and death. 2012. (accessed 22 April 2018)

Royal College of Nursing. Communication. 2016. (accessed 12 February 2019)

Establishing a structured plan to provide high-quality end-of-life care in community settings

02 March 2019
Volume 24 · Issue 3


The purpose of this project was to explore how registered community nurses experienced providing holistic end-of-life care and how having a structured end-of-life care pathway plan would help develop their knowledge and skills, particularly in respect of communication and their ability and confidence in providing evidence-based compassionate care. For some practitioners there exists a lack of confidence surrounding end of life care, which can result in nurses' reluctance to become involved and avoid engaging in those ‘difficult conversations’. Following implementation, early reviews from practice suggest that incorporating the 19 steps of the plan into the delivery of community-based care at end of life has enhanced practice and patient experience.

It is estimated that 1% of the global population dies each year, and this value is predicted to increase by 17% in the future (Royal College of General Practitioners and Royal College of Nursing, 2012). Statistics show that about 35% of these deaths are home deaths, with 18% of individuals dying in their own homes and 17% dying in a care home. Reportedly, 60–70% are not dying in their preferred environment (Royal College of General Practitioners and Royal College of Nursing, 2012). It is suggested that 70% of patients would prefer to die at home, but only half achieve this (Dying Matters, 2018).

Nurses are believed to have the best opportunity to influence the dying process, because of their closeness to patients and their families. Of all healthcare professionals, nurses are said to spend the most time with the patient, and patients and their families look to the nurse for support and guidance (Mauk, 2013). This is especially true for community and home nursing services and when patients wish to die in their own homes. Thus, it is important that community nurses be adequately prepared and skilled to support such patients.

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