WMQRS Good Practice Event
Implementing Amber Care Bundle
to improve End of life care.
The use of the AMBER Care Bundle complies
with the NICE Quality Standard QS013 - End
of life care for adults & Peer Review SelfAssessment for clinical teams i.e.
COPD/Cardiology
Liverpool Care Pathway –
Best practice Tool used on all
adult wards for patients in
the last days of life where
there is deemed no
reversible cause for their
deterioration.
What does it do?
• Gap between health
and dying with
uncertain outcome
• Ability to recover or
deteriorate
• Communication issues
• DNACPR
• Ceiling of Care
• Communication
–
–
–
–
Situation
Plan
Choices – PPC/PPD
Advance Decisions
Benefits include –
• improved decision making
• positive impact on multi-professional team
communication & working
• increase in nurses’ confidence about approaching
medical colleagues to discuss treatment plans
• patients are treated with greater dignity & respect
• greater clarity around patient preferences & how they
can be achieved
• reduction in unnecessary interventions &
readmissions
Why implement AMBER on a Respiratory Ward ?
• Reduce the number of patient deaths on the ward
• To improve the gap in the quality of care for those
on the LCP
• Support active treatment alongside an end of life
care plan and symptom manage.
FOR MANY COPD PATIENTS RECOVERY IS UNCERTAIN
AND READMISSION RATES ARE HIGH, WE SHOULD BE
ASKING:
Is the patient deteriorating, clinically unstable and with
limited reversibility?
Is the patient at risk of dying in the next 1-2 months?
Facts :
• People with respiratory conditions are the
most likely to die in hospital and the least
likely to die at home.
•
14 % of all deaths in England are attributed
to respiratory disease rising to 20% if lung
cancer is included.
• 69% of people with respiratory conditions
(other than lung cancer) die in hospital –
higher than any other condition
• 10% of deaths involving pneumonia or acute
respiratory infection die at home
Acute/community interface
• Rapid Discharge Pathway
• Produced an Electronic Discharge Summary
page
• Out of Hours Form
• Community Prescribing – PRN drugs EOL
• Talk at Local/National Conferences etc.
Contact Details for further information
End of life Care Facilitators at Worcestershire Acute
Hospital Trust
Teresa.Barley@worcsacute.nhs.uk
&
Jennifer.Garside@worcsacute.nhs.uk