Children and young people can have a wide range of life limiting conditions and may sometimes live with such conditions for many years. This guideline recommends that end of life care be managed as a long term process that begins at the time of diagnosis of a life limiting condition and entails planning for the future. Sometimes it may begin before the child’s birth. It is part of the overall care of the child or young person and runs in parallel with other active treatments for the underlying condition itself. Finally, it includes those aspects related to the care of the dying.
Bereaved people in England rate the care provided by hospitals at the end of their relative’s life lower than that provided by hospices, care homes, and services in the community, show the results of a survey published by the Office for National Statistics.
Here are the latest topics for this month from NICE – Eyes on Evidence.
Adenotonsillectomy in children with obstructive sleep apnoea
A randomised controlled trial in the USA finds that adenotonsillectomy does not improve cognitive function in children with obstructive sleep apnoea syndrome, although it does have a beneficial effect on symptoms of sleep apnoea.
Ibuprofen compared with indometacin for patent ductus arteriosus
A Cochrane review reports that ibuprofen is as effective as indometacin for closure of patent ductus arteriosus in preterm or low-birthweight babies, and is associated with a lower risk of necrotising enterocolitis, reduced time on assisted ventilation and a lower risk of negative effects on renal function.
Gallbladder removal with or without bile duct imaging
A retrospective cohort study of US data raises caution about interpreting the benefits of using bile duct imaging during gallbladder removal.
Collaborative care for depression
A cluster randomised controlled trial in English general practices suggests that collaborative care delivered by mental health workers acting as care managers is more effective at reducing depression than usual care.
End-of-life preferences of people with terminal illness who live alone
An Australian cohort study finds that around half of people with terminal illness who live alone would prefer to die at home, but only a small proportion manage to do so.
NICE has recently published Evidence Updates on:
- Venous thromboembolic diseases -Interventions to reduce substance misuse among vulnerable young people
Eyes on Evidence helps contextualise important new evidence, highlighting areas that could signal a change in clinical practice. It does not constitute formal NICE guidance. The commentaries
included are the opinions of contributors and do not necessarily reflect the views of NICE.
The Spring 2014 issue of the free journal for nurses caring for dying people at home, in hospitals and care homes is now available online. This issue is mobile-friendly making it easier to read on your mobile device or tablet.
CLINICAL PRACTICE DEVELOPMENT
NURSING CASE REVIEW
This report sets out recommendations regarding the Liverpool Care Pathway and end of life care following an independent review of the LCP chaired by Baroness Julia Neuberger.
The recommendations include:
- unless there is a very good reason, a decision to withdraw or not to start a life-prolonging treatment should not be taken during any ‘out of hours’ period
- an urgent call for the Nursing and Midwifery Council to issue guidance on end of life care
- a new system-wide approach to improving the quality of care for the dying