Last Offices Policy - Doncaster and Bassetlaw Hospitals NHS ...

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Infection control: Page 4 of 11 REF: PAT/T 30 v.1 Standard precautions should be used with all patients. Leakage of bodily fluids creates an infection control risk; therefore steps should be taken to avoid this. There are some situations which require extra caution when preparing a body for the mortuary, and a body bag may need to be used. Please see appendix 2 for guidance on which diseases require use of a body bag. Equipment: • Bowl, soap, face cloths, towel, razor, comb • Mouth care pack/toothbrush • None absorbent cotton wool • Shroud (or own clothes if specifically requested by family) • Two identification bracelets • Dressing pack/dressings/tape • Body bag (in event of actual/potential leakage of body fluids or infectious disease) • Property book and property bag • Net pants and pad • Clean sheets • Gloves and apron Procedure: 1. Either medical staff or a senior nurse must verify the death, and this should be documented in the patient’s notes. Medical staff must verify an unexpected death. 2. Two members of staff should carry out Last Offices. 3. Offer support and information to family/carer regarding the procedure after death. 4. Sensitively explain to other patients in the area that a patient has died, in order to allay misconceptions and fears. 5. Ensure adequate privacy and dignity whilst performing last offices. 6. Wear gloves and apron. 7. Position the patient on his/her back leaving one pillow in place. Support the jaw with a pillow or rolled up towel, to enable the mouth to close. Straighten the limbs, and align in a natural position with arms at the side. 8. Close the patient’s eyes, if possible, by applying light pressure to the eyelids. 9. Press on the lower abdomen to empty the bladder (unless post mortem is required, when bladder should be left full for toxicology). 10. Remove any mechanical aids such as syringe drivers. 11. Remove any sharps such as butterfly needle and dispose of carefully. 12. Remove drainage tubes and document any tubes remaining such as Hickman lines. (If a post mortem is required leave all tubes in situ)
Page 5 of 11 REF: PAT/T 30 v.1 13. Leave any cannulae in situ, cover and tape. This will prevent unnecessary leakage of bodily fluids. 14. Wash the patient in accordance with religious/cultural needs. Shave male patients if necessary. Family/carers may wish to assist in this as a final act to demonstrate their love and care for the patient. 15. Clean the patient’s mouth and teeth. If possible put patient’s dentures in, if not send the dentures to the mortuary with the body and document this. 16. Remove the patient’s jewellery and document in valuables book. If family request that certain jewellery (e.g. wedding ring) be left on body, this should be documented on the notification of death form. A second member of staff should witness this. Rings should be taped for protection. 17. Pack throat with none absorbent cotton wool. This will prevent the body from vomiting after death, and therefore leakage of bodily fluids. Do not pack throat if it is anticipated that a post mortem may be required. Apply pad and pants to lower body to absorb any leakage of bodily fluids. Cover any wounds with an absorbent dressing and secure with an occlusive dressing. (If a post mortem is required leave existing dressings in situ and cover) 18. If patient’s belongings are soiled, sensitively ask for family’s permission to destroy. Otherwise, send clearly labelled to hospital laundry for cleaning. 19. Dress the patient in a shroud, unless patient/family specifically request own clothes. It is usually more appropriate for funeral directors to dress bodies in own clothes. 20. Complete notification of death form and two identification labels. Attach one label to wrist and one label to opposing ankle. Each label should detail patient’s name, hospital number, ward, date of birth and date of death. If the body is unidentified, label as ‘unidentified male/female’. 21. Wrap the body securely in a sheet ensuring that limbs are held in position and tape securely using a minimal amount of tape, to avoid possible damage to the body during transfer. 22. If a body bag is required, the body does not need to be wrapped in a sheet as above. Document on the notification of death form the reason for using body bag, e.g. leakage or infection. Appendix 2 details situations in which a body bag should be used. 23. Attach one copy of notification of death form to body. 24. Record all care after death within the relevant documentation. 25. Inform shift leader that body is ready for transfer to mortuary. 26. To maintain patient’s dignity, screen off area when porters arrive to collect body. 27. Prepare notes and property for bereavement office/general office.
Page 1 and 2: Page 1 of 11 REF: PAT/T 30 v.1 Last
Page 3: Introduction: Last Offices Policy P
Page 7 and 8: Appendix 1 Cultural/religious varia
Page 9 and 10: Appendix 2 Degree of risk LOW MEDIU
Page 11: Reference list Page 11 of 11 REF: P

Last Offices Policy - Doncaster and Bassetlaw Hospitals NHS ...

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