EPaCCS: Supporting clinical decision making in Out of Hours Care for patients at the end of life

One example is of a lady with ovarian cancer. Her EPaCCS record shared information on diagnosis, prognosis, preferred place of care (PPC), preferred place of death (PPD) and showed that she was prescribed anticipatory medication and a DNACPR form was in place. This allowed me to make decisions comfortably about this patient without having to phone the patient and speak to her or her relatives about her wishes. I was informed out of hours that she had been having haematemesis and that she had dropped her haemoglobin (was becoming anaemic). Because of the EPaCCS record, I knew this lady was in the last days of her life and that her PPC and PPD was home. This allowed me to leave the patient at home, safe in the knowledge that this was her wish, and allowed me to alter the anticipatory medications to ensure she was as symptom free as possible in her last days of life. Without this knowledge, this would have ended up with the patient possibly being visited or even admitted, potentially causing distress to both the patient and family unnecessarily.