Wound care can take a different approach towards the end of life as healing may be an unrealistic aim. We use nursing skills and knowledge to keep the area and the patient as comfortable and contained as possible. Malignant wounds can be caused by direct tumour invasion into the…
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A letter in the recent BMJ Supportive and Palliative care journal(1) has raised questions on the safety of prescribing for 24-hour syringe pumps ahead of need. It reflects that the Gosport War Memorial inquiry has increased public and clinical awareness of the use of syringe pumps for the delivery of opioids…
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This NICE guideline was updated in July 2019 and covers the planning and management of end of life and palliative care for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to improve the support available and involve young people and their families in decisions…
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1. What do we do if we find a fentanyl patch has fallen off? If you have a patch-checking chart, see when it was last observed in place. If it was still on the patient’s skin up to 12 hours ago, apply a new patch as the levels will not have fallen too far. Monitor…
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NG131: Prostate cancer: diagnosis and management. This NICE guideline was published in May 2019 and covers the diagnosis and management of prostate cancer in secondary care, including information on the best way to diagnose and identify different stages of the disease, and how to manage adverse effects of treatment…
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Questions on medicines, procedures and practice from hospice staff 1. Can we crush the patient’s cardiac medication to go via her PEG? Each medication needs to be considered individually as there are specific issues with certain preparations which might not be predicted. Most immediate-release film-coated tablets may be crushed and…
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Pain in the mouth is a distressing problem and affects so many essential activities. It can have many causes and good mouthcare is of enormous benefit to all patients, particularly towards the end of life. NICE guidelines (NG48) and quality standards (QS151) are in place for oral health for adults…
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The registration and naming process for drugs: When new drugs come onto the market, they must be licensed by the Medicines and Healthcare Regulatory Authority (MHRA) and registered with a trade name. Details of most UK medicines and their registration is listed with their Summary of Product Characteristics on the…
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Fluconazole is a triazole antifungal agent which came into use in the late 1980s. It has a different chemical structure to its predecessor, ketoconazole, and is safer systemically. It is licensed for the treatment of topical fungal infections in the mouth, skin and genitals and for invasive, systemic fungal infections…
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This article is largely inspired by a presentation given by Dr Chris Kane, consultant in palliative medicine at Sue Ryder Hospice and the NHS Trust in Leeds, at the The Association of Supportive and Palliative Care Pharmacy annual conference in November 2018. It offered a thought-provoking view on a difficult…
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