This best practice guideline recommends best nursing practices for end-of-life care during the last days and hours of life. The guideline is intended to be a resource to nurses who may not be experts in this practice area.
This best practice guideline recommends best nursing practices for end-of-life care during the last days and hours of life. The guideline is intended to be a resource to nurses who may not be experts in this practice area.
As an introduction, we’ve provided summaries of the practice recommendations from the BPG document — but we strongly encourage downloading RNAO’s official PDF.
Nurses identify individuals who are in the last days and hours of life.
Use clinical expertise, disease-specific indicators and validated tools to identify these individuals.
Understand the end-of-life trajectories.
Nurses understand common signs and symptoms present during the last days and hours of life.
Common signs of imminent death, may include, but are not limited to:
Nurses complete a comprehensive, holistic assessment of individuals and their families based on the Canadian Hospice Palliative Care Association Domains of Care, which include the following:
Include information from multiple sources to complete an assessment. These may include proxy sources, such as the family and other health-care providers.
Use evidence-informed and validated symptom assessment and screening tools when available and relevant.
Reassess individuals and families on a regular basis to identify outcomes of care and changes in care needs.
Communicate assessments to the interprofessional team.
Document assessments and outcomes.
Nurses:
Nurses recognize and respond to factors that influence individuals’ and their families’ involvement in decision-making.
Nurses support individuals and families to make informed decisions that are consistent with their beliefs, values and preferences in the last days and hours of life.
Nurses are knowledgeable about pain and symptom management interventions to enable individualized care planning.
Nurses advocate for and implement individualized pharmacologic and non-pharmacologic care strategies.
Nurses educate and share information with individuals and their families regarding:
Nurses use effective communication to facilitate end of life discussions related to:
This website was developed by a team of researchers at the Daphne Cockwell School of Nursing at Toronto Metropolitan University (Formerly Ryerson University). The purpose of the site is to provide supplementary resources for implementing RNAO’s Best Practice Guidelines. Some information about the best practice guidelines has been collected directly from the RNAO BPG website. We have done our best to ensure accuracy, however some discrepancies may occur. For official, up-to-date information about the best practice guidelines, please refer to the RNAO website.