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Journal articles on the topic 'Liverpool Care Pathway (LCP)'

Author: Grafiati

Published: 11 September 2021

Last updated: 2 February 2022

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1

Jones, Allan R. "The Liverpool Care Pathway for the dying patient: Euthanasia through the back door, or the sign of poor death education?" Ethics & Bioethics 10, no. 1-2 (June 1, 2020): 40–47. http://dx.doi.org/10.2478/ebce-2020-0006.

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AbstractThe Liverpool Care Pathway for the Dying Patient (LCP) was an integrated care pathway for patients in the final days or hours of life, developed at the Royal Liverpool University Hospital in conjunction with the Marie Curie Palliative Care Institute, Liverpool. The LCP became increasingly the normative style of care for patients in the terminal stage across NHS England from the 1990s onwards. Following significant questions raised in Parliament, by the media and other stakeholders, an independent review panel was established under Baroness Neuberger in 2013 to investigate the LCP. The findings of the panel were published as More Care Less Pathway: a Review of the Liverpool Care Pathway identifying significant failings in the delivery of the LCP thus leading to it being phased out some six months later. Rather than being euthanasia through the backdoor, many of the criticisms of the LCP and its poor implementation are indicative of poor communication, limited knowledge of the dying process and a paucity of death education.

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2

van den Berg, Frank. "Liverpool Care Pathway (LCP) in Engeland afgeschaft!" Pallium 15, no. 5 (November 2013): 26–27. http://dx.doi.org/10.1007/s12479-013-0130-8.

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3

Collins, Heather, and Peter Raby. "Palliative care after the Liverpool Care Pathway: a study of staff experiences." British Journal of Nursing 28, no. 15 (August 8, 2019): 1001–7. http://dx.doi.org/10.12968/bjon.2019.28.15.1001.

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The objective of this study was to explore nurses' perceptions of end-of-life care following the withdrawal of the Liverpool Care Pathway (LCP). Thirteen semi-structured interviews were conducted with nurses working in palliative care. Data were analysed using thematic analysis. Three themes emerged: perceptions of the LCP, prevailing issues, and patients' and families' experiences. This study suggested that the removal of the pathway has not remedied the issues attributed to it. Further, the way in which the LCP was removed indicates that the non-expert media can play a negative role in how palliative care is perceived, which inhibits the care process. In this respect it is important that ‘insider’ voices are also heard, in order to educate and also redress disinformation. Similarly, broader, persisting, contextual challenges facing staff need addressing in order to prevent a repeat of the issues leading to the removal of the LCP.

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4

Hemington-Gorse, S. J., A. J. P. Clover, C. Macdonald, J. Harriott, P. Richardson, B. Philp, O. Shelley, and P. Dziewulski. "Comfort care in burns: The Burn Modified Liverpool Care Pathway (BM-LCP)." Burns 37, no. 6 (September 2011): 981–85. http://dx.doi.org/10.1016/j.burns.2011.03.012.

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5

Lemos Dekker, Natashe, Marjolein Gysels, and Jenny T. van der Steen. "Professional caregivers' experiences with the Liverpool Care Pathway in dementia: An ethnographic study in a Dutch nursing home." Palliative and Supportive Care 16, no. 4 (July 11, 2017): 479–86. http://dx.doi.org/10.1017/s1478951517000645.

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ABSTRACTObjective:There are few studies on how professional caregivers apply the Liverpool Care Pathway (LCP) in nursing home care for people with dementia. Further, despite critiques in the United Kingdom, the LCP continues to be used in the Netherlands, while, to the best of our knowledge, no studies have been conducted since its implementation. The purpose of the present study was to analyze professional caregivers' experiences with the LCP in this context.Method:This article draws on an ethnographic study. Data collection was based on 4 months of ethnographic fieldwork in 2015 in 11 psychogeriatric units of a nursing home in a rural area of the Netherlands. Data collection included participant observation and 25 semistructured audiotaped interviews with specialist elderly care physicians, nursing staff, and a nurse practitioner.Results:We found that professional caregivers appreciate the LCP as a communication tool and as a reminder of care goals. However, the document was deemed too complicated and to cause duplication of work. It was also reported that the LCP did not cover the complexity of care needs that emerge in practice. Actual care needs were prioritized over the LCP, which calls its contribution into question.Significance of Results:Overall, the LCP does not match the context of dementia care in the nursing home. While it could be argued that the LCP does not intend to replace good care, its benefits as a reminder and a communication tool need continued consideration in relation to the amount of work it requires as a bureaucratic obligation.

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6

Grogan, E., L. M. Peel, and E. T. Peel. "Drugs at the End of Life: Does an Integrated Care Pathway Simplify Prescribing?" Journal of integrated Care Pathways 9, no. 2 (August 2005): 78–80. http://dx.doi.org/10.1177/147322970500900206.

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The Liverpool integrated care pathway for the dying patient (LCP) facilitates management of dying patients, but does not provide guidance regarding medication. A retrospective audit was performed of patients using the LCP to assess what medications were required, how requirements changed and which of the four symptoms outlined in the LCP were most troublesome (pain, agitation, sickness and respiratory secretions). Over a five-month period, 68 patients died on the LCP, and were included in the audit. The most unstable symptom (stability defined by rescue medication requirements) at the end of life was agitation − 37 of the 68 patients required regular sedatives and 45 patients needed at least one rescue dose of sedative. Sickness was the most stable symptom − 39 patients needed regular antiemetic, but only three patients needed rescue doses. These findings have implications in writing guidelines for symptom management at the end of life.

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7

Seymour, Jane, and David Clark. "The Liverpool Care Pathway for the Dying Patient: a critical analysis of its rise, demise and legacy in England." Wellcome Open Research 3 (February 22, 2018): 15. http://dx.doi.org/10.12688/wellcomeopenres.13940.1.

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Background: The Liverpool Care Pathway for the Dying Patient (‘the LCP’) was an integrated care pathway (ICP) recommended by successive governments in England and Wales to improve end-of-life care, using insights from hospice and palliative care. It was discontinued in 2014 following mounting criticism and a national review. The ensuing debate among clinicians polarised between ‘blaming’ of the LCP and regret at its removal. Employing the concept of ‘boundary objects’, we aimed to address three questions: 1) why and how did the LCP come to prominence as a vehicle of policy and practice 2) what factors contributed to its demise? 3) what immediate implications and lessons resulted from its withdrawal? Methods: We use primary and secondary sources in the public domain to assemble a critical and historical review. Results: The rapidity of transfer and translation of the LCP reflected uncritical enthusiasm for ICPs in the early 2000s. The subsequent LCP ‘scandal’ demonstrated the power of social media in creating knowledge, as well as conflicting perceptions about end-of-life interventions. While the LCP had some weaknesses in its formulation and implementation, it became the bearer of responsibility for all aspects of NHS end-of-life care. This was beyond its original remit. It exposed fault lines in the NHS, provided a platform for debates about the ‘evidence’ required to underpin innovations in palliative care and became a conduit of discord about ‘good’ or ‘bad’ practice in care of the dying. It also fostered a previously unseen critique of assumptions within palliative care. Conclusions: In contrast to most observers of the LCP story who refer to the dangers of scaling up clinical interventions without an evidence base, we call for greater assessment of the wider risks and more careful consideration of the unintended consequences that might result from the roll out of new end-of-life interventions.

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Seymour, Jane, and David Clark. "The Liverpool Care Pathway for the Dying Patient: a critical analysis of its rise, demise and legacy in England." Wellcome Open Research 3 (April 24, 2018): 15. http://dx.doi.org/10.12688/wellcomeopenres.13940.2.

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Background: The Liverpool Care Pathway for the Dying Patient (‘LCP’) was an integrated care pathway (ICP) recommended by successive governments in England and Wales to improve end-of-life care. It was discontinued in 2014 following mounting criticism and a national review. Understanding the problems encountered in the roll out of the LCP has crucial importance for future policy making in end of life care. We provide an in-depth account of LCP development and implementation with explanatory theoretical perspectives. We address three critical questions: 1) why and how did the LCP come to prominence as a vehicle of policy and practice? 2) what factors contributed to its demise? 3) what immediate implications and lessons resulted from its withdrawal? Methods: We use primary and secondary sources in the public domain to assemble a critical and historical review. We also draw on the ‘boundary object’ concept and on wider analyses of the use of ICPs. Results: The rapidity of transfer and translation of the LCP reflected uncritical enthusiasm for ICPs in the early 2000s. While the LCP had some weaknesses in its formulation and implementation, it became the bearer of responsibility for all aspects of NHS end-of-life care. It exposed fault lines in the NHS, provided a platform for debates about the ‘evidence’ required to underpin innovations in palliative care and became a conduit of discord about ‘good’ or ‘bad’ practice in care of the dying. It also fostered a previously unseen critique of assumptions within palliative care. Conclusions: In contrast to most observers of the LCP story who refer to the dangers of scaling up clinical interventions without an evidence base, we call for greater assessment of the wider risks and more careful consideration of the unintended consequences that might result from the roll out of new end-of-life interventions.

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9

Clark, David, Hamilton Inbadas, and Jane Seymour. "International transfer and translation of an end of life care intervention: the case of the Liverpool Care Pathway for the dying patient." Wellcome Open Research 5 (October 27, 2020): 256. http://dx.doi.org/10.12688/wellcomeopenres.16321.1.

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We explore how and why the Liverpool Care Pathway (LCP) for the dying patient was transferred to 20 countries beyond the UK, and with what consequences for policy and practice. Our paper synthesises findings from 95 publications contained in a historical narrative literature review on the implementation of the LCP outside the United Kingdom, alongside data from 18 qualitative interviews with 19 key actors involved with the LCP in 14 countries. We use the review to explore the timelines and patterns of development and implementation in the specific countries, to consider what forms of research and evaluation about the LCP were undertaken to establish its effectiveness, and to summarise the resulting findings and their consequences. We use the interviews to gain insights into the elements, processes and dynamics that shaped the transfer and translation of the LCP from one location to another, across national boundaries. Using six questions from the policy transfer literature we then explain who were the key actors involved; what was transferred; from where lessons were drawn; the different degrees of transfer that took place; what restricted or facilitated transfer; and how transfer was related to ‘success’ or ‘failure’. We conclude that the spread of the LCP took place mostly in prosperous countries, and was sustained over around 15 years. It took in differing geographies and cultures, and a variety of linguistic, policy and practice contexts. If it did not succeed in a wider transformational goal, it appears to have been well received and perceived as beneficial in many contexts, largely avoiding accusations of mis-use and harm that had occurred in the UK, and in some cases fostering a sustained international collaboration and ongoing use of local variants, even after withdrawal in its country of origin in 2014.

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10

Simon, S., M. Martens, M. Sachse, C. Bausewein, S. Eychmüller, and M. Schwarz-Eywill. "Sterbebegleitung im Krankenhaus – erste Erfahrungen mit dem „Liverpool Care Pathway” (LCP) in Deutschland." DMW - Deutsche Medizinische Wochenschrift 134, no. 27 (June 23, 2009): 1399–404. http://dx.doi.org/10.1055/s-0029-1225295.

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11

Ellershaw, John E., and Deborah Murphy. "The Liverpool Care Pathway (LCP) influencing the UK national agenda on care of the dying." International Journal of Palliative Nursing 11, no. 3 (March 2005): 132–34. http://dx.doi.org/10.12968/ijpn.2005.11.3.18032.

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12

Costantini, Massimo, Silvia Di Leo, and Monica Beccaro. "Methodological issues in a before-after study design to evaluate the Liverpool Care Pathway for the Dying Patientin hospital." Palliative Medicine 25, no. 8 (August 10, 2011): 766–73. http://dx.doi.org/10.1177/0269216311418870.

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Background: In 2006, as the first step of a 3-year research programme to assess the Liverpool Care Pathway for the Dying Patient (LCP) in hospital, the original LCP documentation was translated and piloted in four Italian hospital wards in Genoa. The primary aim was to evaluate the feasibility of LCP implementation in the Italian context. The secondary aim of the study was to evaluate the effectiveness of the LCP with an uncontrolled before–after design. Aim: The aim of the study was to discuss and critically evaluate the methodological issues in designing and interpreting the results of the before–after study design. Setting/participants: All cancer deaths which occurred in four hospital wards (three general medicine and one respiratory disease) 4 months before and 4 months after LCP implementation (2 months for the respiratory disease ward) were registered. Caregivers were interviewed after the patient’s death using the Toolkit After-Death Bereaved Family Member Interview. Results: A total of 111 cancer deaths were identified (63 before and 48 after) and 79 caregivers (71.2%) were interviewed (46 before and 33 after). The analyses on number and characteristics of the patients, interviewed caregivers, compliance and modality of assessment showed significant differences before and after. A remarkable internal correlation coefficient for all of the Toolkit scales within the four hospital wards was observed. Conclusions: This analysis confirms the high risk of selection and information bias inherent the uncontrolled before– after study design. The high internal correlation strongly suggests that clustering should be taken into account in this kind of study.

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13

Ramasamy Venkatasalu, Munikumar, Dean Whiting, and Karen Cairnduff. "Life after the Liverpool Care Pathway (LCP): a qualitative study of critical care practitioners delivering end-of-life care." Journal of Advanced Nursing 71, no. 9 (May 14, 2015): 2108–18. http://dx.doi.org/10.1111/jan.12680.

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14

Leo, Silvia Di, Laura Bono, Vittoria Romoli, Emily West, Raffaella Ambrosio, Michele Gallucci, Paola Pilastri, et al. "Implementation of the Liverpool Care Pathway (LCP) for the Dying Patient in the Inpatient Hospice Setting." American Journal of Hospice and Palliative Medicine® 31, no. 1 (April 9, 2013): 61–68. http://dx.doi.org/10.1177/1049909113482355.

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15

Perkins, Elizabeth, Maureen Gambles, Rachel Houten, Sheila Harper, Alan Haycox, Terri O’Brien, Sarah Richards, Hong Chen, Kate Nolan, and John E. Ellershaw. "The care of dying people in nursing homes and intensive care units: a qualitative mixed-methods study." Health Services and Delivery Research 4, no. 20 (June 2016): 1–410. http://dx.doi.org/10.3310/hsdr04200.

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BackgroundIn England and Wales the two most likely places of death are hospitals (52%) and nursing homes (22%). The Department of Health published its National End of Life Care Strategy in July 2008 (Department of Health.End of Life Care Strategy: Promoting High Quality Care For All Adults at the End of Life. London: Department of Health; 2008) to improve the provision of care, recommending the use of the Liverpool Care Pathway for the Dying Patient (LCP).AimThe original aim was to assess the impact of the LCP on care in two settings: nursing homes and intensive care units (ICUs).DesignQualitative, matched case study.MethodsData were collected from 12 ICUs and 11 nursing homes in England: (1) documentary analysis of provider end-of-life care policy documents; (2) retrospective analysis of 10 deaths in each location using written case notes; (3) interviews with staff about end-of-life care; (4) observation of the care of dying patients; (5) analysis of the case notes pertaining to the observed patient’s death; (6) interview with a member of staff providing care during the observed period; (7) interview with a bereaved relative present during the observation; (8) economic analysis focused on the observed patients; and (9) strict inclusion and selection criteria for nursing homes and ICUs applied to match sites on LCP use/non-LCP use.ResultsIt was not possible to meet the stated aims of the study. Although 23 sites were recruited, observations were conducted in only 12 sites (eight using the LCP). A robust comparison on the basis of LCP use could not, therefore, take place. Although nurses in both settings reported that the LCP supported good care, the LCP was interpreted and used differently across sites, with the greatest variation in ICUs. Although not able to address the original research question, this study provides an unprecedented insight into care at the end of life in two different settings. The majority of nursing homes had implemented some kind of ‘pathway’ for dying patients and most homes participating in the observational stage were using the LCP. However, training in care of the dying was variable and specific issues were identified relating to general practitioner involvement, the use of anticipatory drugs and the assessment of consciousness and the swallowing reflex. In ICUs, end-of-life care was inextricably linked with the withdrawal of active treatment and controlling the pace of death. The data highlight how the decision to withdraw was made and, importantly, how relatives were involved in this process. The fact that most patients died soon after the withdrawal of interventions was reported to limit the appropriateness of the LCP in this setting.LimitationsAlthough the recruitment of matched sites was achieved, variable site participation resulted in a skewed sample. Issues with the sample size and a blurring of LCP use and non-use limit the extent to which the ambitious aims of the study were achieved.ConclusionsThis study makes a unique contribution to understanding the complexity of care at the end of life in two very different settings. More research is needed into the ways in which an organisational culture can be created within which the principles of good end-of-life care become translated into practice.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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16

Parsons, D., M. Gambles, and L. Chapman. "Implementing the Liverpool Care Pathway for the Dying Patient in Intensive Care Version 12 (LCP ICU V12) across a regional critical care network." BMJ Supportive & Palliative Care 2, no. 2 (June 2012): 5.2–5. http://dx.doi.org/10.1136/bmjspcare-2012-000264.15.

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17

Karthaus, Meinolf, J. Riesle-Keil, Ursula Weber, and Ingeburg Wolf. "Implementation of an End-of-Life Care Pathway in Cancer Patients." Blood 120, no. 21 (November 16, 2012): 4689. http://dx.doi.org/10.1182/blood.v120.21.4689.4689.

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Abstract Abstract 4689 Background: Supportive care for dying hemato-oncological patients in the hospital remains an unmet need. The Liverpool Care Pathway (LCP) has been developed in Europe for patients in the final 24–72 h of life to help physicians and nurses in the end-of-life care (ELC). We evaluated appropriately timed cessation of treatment in a Hemato-Oncology Department after integration of a modified LCP in a tertiary Munich cancer center. The End-of-life Care Pathway was modified to suit local conditions. The aim of the trial was to include over 40% of dying patients in the ELC. The effectiveness of symptom control which included termination of not necessary drugs, sufficient pain relief, control of agitation, bronchial fluid secretion, dyspnoea, nausea and emesis was compared with a control group (CG). The ELC was in accordance to local ethics. Nurses and physicians were trained. The ELC was periodically reviewed by a local multidisciplinary steering group for improvements. Patients and Methods: From 01/10 until 06/11 a total of 228 cancer deaths were observed. Criteria for entry onto the ELC were that the multidisciplinary team agreed the patient was dying, and was at least two of the following: bedbound; semi-comatose; only able to take sips of fluid; no longer able to take tablets. 96 pts (41 male/55 female) went on the ELC (42%), while 132 dying cancer pts were not enrolled due to a variety of reasons (e.g. lack of informed consent, rapid deterioration). The mean age was 72,6 ys (range 33 to 91 ys). The median duration of ELC use was 41,3 hours (range 0.5 to 189 h). Six patients improved after they had entered the ELC and left the ELC consecutively. Out of these four patients reentered the ELC and died, one of these six patients died without being reentered on the ELC. Symptom control (ELC/CG in %) was achieved in pain in 92/50%; agitation 89/50%, nausea 96/40%, dyspnoea 92/55% while unnecessary medication was terminated in 95/90%. All patients had current medication assessed and non-essential drugs were discontinued. Inappropriate interventions with antibiotics (85/65%), blood tests (95/75%), iv fluids (90/70%) were terminated more often when pts entered the ELC. Conclusion: Integration of an ELC in a hematology unit provides a better symptom control for dying patients. Inappropriate interventions could be reduced. Appropriate template design and supervision are the keys to success for end-of-life care in cancer patients. Disclosures: No relevant conflicts of interest to declare.

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18

George, Rob, Jonathan Martin, and Vicky Robinson. "The Liverpool Care Pathway for the Dying (LCP): Lost in translation and a tale of elephants, men, myopia – and a horse." Palliative Medicine 28, no. 1 (December 20, 2013): 3–7. http://dx.doi.org/10.1177/0269216313514706.

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19

Kanno, Yusuke, Kazuki Sato, Yoko Hayakawa, Yoshie Takita, Takashi Agatsuma, Tomoko Chiba, Kazuko Honda, et al. "The burden of introducing the Japanese language version of the Liverpool Care Pathway（LCP-J）for dying patients in general wards and their families：experience of health care professionals in a university hospital." Palliative Care Research 10, no. 1 (2015): 318–23. http://dx.doi.org/10.2512/jspm.10.318.

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20

Evans, Roger. "The Liverpool Care Pathway." Nursing Standard 27, no. 14 (December 5, 2012): 30. http://dx.doi.org/10.7748/ns2012.12.27.14.30.p10091.

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21

Rady, Mohamed Y., and Joseph L. Verheijde. "Liverpool Care Pathway: life-ending pathway or palliative care pathway?" Journal of Medical Ethics 41, no. 8 (July 18, 2014): 644. http://dx.doi.org/10.1136/medethics-2014-102314.

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22

Mullick, A., T. Beynon, M. Colvin, M. Morris, L. Shepherd, L. Cave, J. Lowell, N. Asmall, and I. Carey. "Liverpool care pathway carers survey." Palliative Medicine 23, no. 6 (May 21, 2009): 571–72. http://dx.doi.org/10.1177/0269216309106459.

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23

Senior-Smith, Gaye, and Colette Reid. "Liverpool Care Pathway post review." British Journal of Cardiac Nursing 8, no. 8 (August 2013): 361. http://dx.doi.org/10.12968/bjca.2013.8.8.361.

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24

Hutchinson, Lisa. "Benefits of Liverpool Care Pathway." Nature Reviews Clinical Oncology 10, no. 12 (November 5, 2013): 671. http://dx.doi.org/10.1038/nrclinonc.2013.210.

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Becker, Robert. "The Liverpool Care Pathway explained." Nursing and Residential Care 15, no. 4 (April 2013): 210–13. http://dx.doi.org/10.12968/nrec.2013.15.4.210.

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26

Livesley, Brian. "The Pseudo-Liverpool Care Pathway." British Journal of Healthcare Management 19, no. 2 (February 2013): 58–59. http://dx.doi.org/10.12968/bjhc.2013.19.2.58.

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27

Al-Benna, Sammy. "Burn care and the Liverpool Care Pathway." Burns 39, no. 5 (August 2013): 1028. http://dx.doi.org/10.1016/j.burns.2013.01.001.

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O'Dowd, A. "Liverpool care pathway: doctors speak out." BMJ 345, no. 14 1 (November 14, 2012): e7644-e7644. http://dx.doi.org/10.1136/bmj.e7644.

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Green, Tony. "Liverpool Care Pathway still being used." Nursing Management 21, no. 10 (March 2, 2015): 6. http://dx.doi.org/10.7748/nm.21.10.6.s2.

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Ison, Lucy, Dominique Wakefield, and Irene Carey. "Postscript to the Liverpool Care Pathway." BMJ Supportive & Palliative Care 9, no. 2 (July 4, 2018): 225. http://dx.doi.org/10.1136/bmjspcare-2018-001573.

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Chipp, Elizabeth, Patricia Richardson, Judith Harriott, Bruce Philp, Peter Dziewulski, and Sarah Hemington-Gorse. "Re: Burn Care and the Liverpool Care Pathway." Burns 40, no. 2 (March 2014): 358–59. http://dx.doi.org/10.1016/j.burns.2013.08.028.

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32

Sleeman, KE. "The Liverpool Care Pathway: benefit or harm?" Journal of the Royal College of Physicians of Edinburgh 44, no. 3 (2014): 214–15. http://dx.doi.org/10.4997/jrcpe.2014.306.

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Nauck, F. "H7.2. Liverpool Care Pathway of the Dying." Perioperative Medizin 1, no. 4 (December 2009): 245. http://dx.doi.org/10.1016/j.periop.2009.08.025.

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Sykes, Nigel. "The end of the Liverpool Care Pathway?" Lancet Oncology 14, no. 10 (September 2013): 926–27. http://dx.doi.org/10.1016/s1470-2045(13)70379-6.

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Sleeman, K. E., and E. Collis. "The Liverpool care pathway: a cautionary tale." BMJ 347, jul31 1 (July 31, 2013): f4779. http://dx.doi.org/10.1136/bmj.f4779.

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McCartney, M. "The assault on the Liverpool care pathway." BMJ 345, oct30 3 (October 30, 2012): e7316-e7316. http://dx.doi.org/10.1136/bmj.e7316.

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37

Kmietowicz, Z. "Health professionals defend the Liverpool care pathway." BMJ 345, no. 06 2 (November 6, 2012): e7511-e7511. http://dx.doi.org/10.1136/bmj.e7511.

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38

Kirk, Rebecca. "The realities of the Liverpool care pathway." Nature Reviews Clinical Oncology 10, no. 2 (January 30, 2013): 61–62. http://dx.doi.org/10.1038/nrclinonc.2013.3.

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39

Grossenbacher-Gschwend, B., and S. Eychmüller. "Der Liverpool Care Pathway of the dying." Der Onkologe 13, no. 4 (April 2007): 343–49. http://dx.doi.org/10.1007/s00761-006-1178-4.

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40

Tingle, John. "End-of-life care: replacing the Liverpool Care Pathway." British Journal of Nursing 23, no. 14 (July 24, 2014): 816–17. http://dx.doi.org/10.12968/bjon.2014.23.14.816.

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Middleton-Green, Laura. "End-of-life care after the Liverpool Care Pathway." British Journal of Community Nursing 19, no. 5 (May 2014): 250–54. http://dx.doi.org/10.12968/bjcn.2014.19.5.250.

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Smith, James P. "Concerns about Liverpool care pathway should be heeded." Nursing Standard 27, no. 11 (November 14, 2012): 31. http://dx.doi.org/10.7748/ns2012.11.27.11.31.p9957.

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Smith, James P. "Concerns about liverpool care pathway should be heeded." Nursing Standard 27, no. 11 (November 14, 2012): 31. http://dx.doi.org/10.7748/ns.27.11.31.s45.

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Duffy, Anne, and Claire Woodland. "Introducing the liverpool care pathway into nursing homes." Nursing Older People 18, no. 9 (October 2006): 33–36. http://dx.doi.org/10.7748/nop.18.9.33.s19.

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45

Blakemore, Sophie. "Nurses seek better training in Liverpool Care Pathway." Cancer Nursing Practice 12, no. 4 (May 2013): 5. http://dx.doi.org/10.7748/cnp2013.05.12.4.5.s7.

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Chinthapalli, K. "The Liverpool care pathway: what do specialists think?" BMJ 346, feb27 3 (February 27, 2013): f1184. http://dx.doi.org/10.1136/bmj.f1184.

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Müller, E., M. H.-D. Pfisterer, and P. Oster. "Der Einsatz des „Liverpool Care Pathway” im Pflegeheim." DMW - Deutsche Medizinische Wochenschrift 134, no. 37 (September 2009): 1838. http://dx.doi.org/10.1055/s-0029-1237523.

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Brewer, C. "Liverpool care pathway is a half baked compromise." BMJ 345, no. 13 4 (November 13, 2012): e7629-e7629. http://dx.doi.org/10.1136/bmj.e7629.

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Tingle, John. "Why the Liverpool Care Pathway should be replaced." British Journal of Nursing 22, no. 16 (September 2013): 976–77. http://dx.doi.org/10.12968/bjon.2013.22.16.976.

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Nellist, Emily. "The Liverpool Care Pathway: a tool for paramedics?" Journal of Paramedic Practice 3, no. 4 (April 2, 2011): 186–89. http://dx.doi.org/10.12968/jpar.2011.3.4.186.

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