Anticipatory medications in a community palliative care service.

It is an established practice in our community palliative care service (CPCS) to have subcutaneous medications supplied to our patients, kept in their homes, for use by our nursing staff if called out for unstable symptoms. These have been termed "emergency medications" and are frequently requested at admission to the service using a standard medication list. A prospective audit undertaken of the aforementioned practice revealed that it was time consuming, orders were at times difficult to obatin and a high rate of inappropriate orders were discovered. A working group was subsequently formed to review the recommendations made from the audit. Key outcomes of the working group include: 1) Use and definition of the term "Anticipatory medication" instead of emergency medication.2) Development of criteria and policy to guide the prescribing and provision of anticipatory medication, incorporating the use of PCOC phases in this process. Development of a new process for the supply of anticipatory medication after hours when GP not available. 4) New documentation recording medication use, dispensing and communication to the GP.5) Development of a program to teach caregivers to administer S/C medications when required during end of life care utilising the PCOC phases to guide the implementation of the program. This presentation will include findings and recommendations from the audit as well as details of the outcomes of the working group