Sourcebook : 6.2 Improve Clinicians' Communication Skills : 6.2.2 Case Study - Dartmouth-Hitchcock Medical Center

Learning to Pronounce Death

Finding that many clinicians did not appreciate the emotional significance of the pronouncement of death to family members or the basics of good communication with families, Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, developed a pocket card to guide clinicians through the steps of pronouncing a patient dead.

Quick Reference Card for Pronouncement of Death - Dartmouth-Hitchcock Medical Center
Recognize the extreme emotional significance of the actual pronouncement of death to family members in room Establish eye contact with family member(s) present Introduce self to family Examine patient for absence of breath sounds and heart sounds Note time of death After confirmation of death, verbally acknowledge patient’s death to family Communicate condolences verbally (i.e., “I’m sorry for your loss.”) or non-verbally Determine legal next-of-kin from chart face sheet Ask legal next-of-kin about autopsy, organ donation, funeral home name (family can call it in later) Nurse/secretary will contact Deceased Patient Coordinator to help complete the paperwork Notify attending MD of death

Quick Reference Card for Pronouncement of Death - Dartmouth-Hitchcock Medical Center

Recognize the extreme emotional significance of the actual pronouncement of death to family members in room
Establish eye contact with family member(s) present
Introduce self to family
Examine patient for absence of breath sounds and heart sounds
Note time of death
After confirmation of death, verbally acknowledge patient’s death to family
Communicate condolences verbally (i.e., “I’m sorry for your loss.”) or non-verbally
Determine legal next-of-kin from chart face sheet
Ask legal next-of-kin about autopsy, organ donation, funeral home name (family can call it in later)
Nurse/secretary will contact Deceased Patient Coordinator to help complete the paperwork
Notify attending MD of death

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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.

For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].