ABSTRACT
This article identifies the most significant elements of the process of nurse attention to the last days and hours of life in the context of a disease previously diagnosed like a terminal situation. For this object, we have reviewed the main clinical guidelines on comprehensive care and, especially, the guideline that was designed by the Saint John of God Hospital in Seville. We conclude that it is necessary to know how to identify the phase of agony to apply, therefore a default care plan that, allows to respond customized to the specific needs that occur in the last hours of the life of a terminal patient. A continued and coordinated interprofessional assistance to patient and family following standardized standards allows achieving a peaceful death and free from avoidable suffering.
Subject(s)
Comprehensive Health Care , Nursing , Terminal Care , HumansABSTRACT
OBJECTIVE: To analyze the influence of hospital size on efficient delivery of health care to patients admitted with respiratory problems in Andalusia (Spain). METHOD: From the minimal data base of all public hospital releases from Andalusia for 1994 and 1995, we identified patients whose main diagnosis involved respiratory complaints as shown by diagnosis-related grouper AP-DRG-10.0, excluding patients aged under 15 years. A functional index for each hospital was calculated to estimate hospital efficiency; a case-mix index was used to express the complexity of cases attended. RESULTS: 1) The case-mix indexes of the hospitals studied were not significantly different. Functional indexes were positively related to hospital size. CONCLUSIONS: 1) In Andalusia, case complexity does not increase with the size of public hospital. 2) Larger hospital size led to decreased efficiency in caring for respiratory patients in the population and period under study.
