Care pathways in the hospice setting: Doctors and Nurses Perceptions of using the Liverpool Care of the Dying Pathway

Background: The use of care pathways has escalated in the last decade in the UK. Within palliative care the Liverpool Care of the Dying Pathway (LCP) was originally developed to transfer best practice from the hospice setting into the acute hospital sector, and has since been modified for use in the hospice, community and nursing homes (Ellershaw and Wilkinson, 200�). This mulitprofessional pathway provides an evidence based framework for the dying phase. Providing guidance on the different aspects of care required including: comfort measures, anticipatory prescribing of medication, and discontinuation of inappropriate interventions. Additionally psychological and spiritual care and family support is included. Evaluation of the impact of the LCP within the hospital identified the value of the LCP (Jack et al 200�). This study aimed to explore nurses and doctors perception of using the LCP within the hospice setting. Methodology: A qualitative approach using tape recorded semi structured interviews was adopted for the study. A purposive sampling of doctors and nurses familiar with the LCP working at various grades in the hospice were invited to participate in the study. Data were analysed for emerging themes using case and cross case analysis by two researchers. Results and Discussion: A total of 11 interviews were undertaken (8 nurses, � doctors). The results suggest that the doctors and nurses, despite some initial scepticism at its introduction, have found the LCP to have a positive impact. Benefits in the continuity of care, reducing documentation and promoting the needs of the family were identified. The additional value as a tool for educating new staff and to promote research and audit were highlighted. This paper discusses the results and explores potential reasons for the findings