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Advance care planning and syringe drivers in palliative and end-of-life care

24 September 2020
Clinical
02 September 2020
Volume 29 · Issue 17

Abstract

This article discusses the practicalities of syringe drivers (subcutaneous continuous infusion pumps) for symptom control in patients requiring palliative or end-of-life care, which may form part of an advance care plan. It includes a discussion of palliative and end-of-life care, advance care planning, and when a syringe driver might be beneficial for the patient. It also provides step-by-step clinical guidance on setting up a syringe driver.

Palliative and end-of-life care is an important aspect of nursing. Around 500 000 people die in England every year and it is expected that, by 2040, this will rise to 590 000 (Dying Matters, 2020). The main aetiology of death is stroke and heart failure; however, one in four people in the UK will die of cancer (Office for National Statistics (ONS), 2020). It should also be appraised that due to an increasing and ageing population, a significant proportion of older adults will be living with comorbidity and therefore an increase in deaths due to comorbidity and frailty will likely pertain as a leading course of mortality in the coming years (National Institute for Health and Care Excellence (NICE), 2016). In response to this, nurses need to be managing and delivering services that can identify and care for people who require palliative care and are likely to be approaching the end of their lives (NICE, 2019).

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Symptom control
Subcutaneous infusion
Medication management
Patient-centred care