Integrated palliative care within a general hospital

The goal of the project was to integrate essential elements of palliative care into the regular duties of an internal ward located in a general hospital serving a rural area. To achieve this goal, the medical and nursing staff was moderately expanded, which was made possible by a grant from the Deutsche Krebshilfe, and training and supervision were instituted. Patients with malignant diseases in advanced and terminal phases were enrolled in the project and evaluated using a specifically designed documentation system. On average, 8.5 (18%) of the 46 beds on the ward were occupied by patients being cared for as part of the project at any one time. Effective relief of pain, nausea and respiratory distress were documented. For those dying in the hospital, a single room and the presence of family members were possible in the majority of cases. A high impact on the team became apparent through an anonymous questionnaire given during supervision. The project shows that it is possible to integrate palliative care into the work of a regular internal medical ward, with positive consequences for the patients and the team.