Unleashing and Embracing the Possibilities- Implementing an End of Life Care Plan in the Acute Care Setting.

Ms Anna Nicholas1

1THS – Royal Hobart Hospital, Hobart, Australia


Evidence demonstrates that a majority of Australians die in the Acute Care Setting, recognising this may not be their preference. Delivering optimal care at End of life for patients and their families can be complex due to multifactorial reasons.

In Tasmania, there were 4,500 deaths in 2020, 870 of these occurred at the Royal Hobart Hospital.

This presentation will discuss the development of The State-wide End of Life Care Plan developed in relation to the NSQHS, Comprehensive Care Standard 5.

This multidisciplinary care plan aims to ensure, a comprehensive assessment is completed, including patient and family wishes, ensure unnecessary interventions are ceased, improve symptom management, provide medication guidelines for prescribing for End of Life Care, and a Track and Trigger chart specific to monitoring both physical and psychological symptoms.

The implementation of this Plan is currently being trialled across the State in the Acute and Sub Acute Settings. A comprehensive education plan is being delivered for Nursing and Medicine, pertaining to the plan as well as broader End of Life education needs such as identifying dying, communication training in ‘Breaking bad news’, empathy and discussing Goals of Care.

The End of Life Care Plan provides prompts for conversations, assessment, and symptom relief. This plan is a tool to improve end of life care in the Acute Care setting by empowering both nursing and medicine to embrace the clinical skills they have in caring for the dying and support development to improve the experience for clinicians, the patient and their families


Anna Nicholas is currently working as a Project Officer in End of Life Care in the Acute Care Setting. This role has encompassed the development of the State Wide End of Life Care Plan and the education strategy to both nursing and medicine. She has worked as a Clinical Nurse Consultant in Palliative Care in the Acute Care Setting and the Community for the last 20 years both here and in New South Wales. She has completed her Masters Degree in Palliative Care through Flinders University and has a passion for improving End of Life Care in Acute Care.