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Background Addressing patients' spiritual needs has been found to improve remaining quality of life and the ability to cope with ill health (Wynne L, Nursing Standard, 2013, 28, 2, 41-45), yet it is a factor often overlooked in end of life care (Tuck C, Scottish Journal of Healthcare Chaplaincy, 2009, 12: 2, 52-9). This audit sought to investigate if the spiritual needs of patients and their next of kin were being addressed at the end of life.
Intervention Two loops of this audit were completed - the second cycle following an intervention of a teaching session to DoME junior doctors and a poster presentation. These included the importance of spiritual needs assessment at the end of life and issues surrounding its implementation.
Improvement 12.5% of patients that weren't documented as ‘unable to communicate’ had their spiritual needs assessed in the baseline audit and this improved to 33% following the teaching session. 28% of next of kin had their spiritual needs assessed in the baseline audit, and this remained stable at 29% following the teaching session.
Discussion The changes were challenging to evaluate as the term ‘spirituality’ is difficult to define and can be interpreted in different ways. Although many people would interpret it as ‘religious beliefs’, it encompasses broader concepts than this, such as core beliefs and values (Holloway, Adamson, McSherry. Department of Health, 2010). The audit results were thought to be due to barriers in assessing spiritual needs amongst the medical team, and lack of awareness that it is a part of good practice guidelines in palliative care. We tried to address these barriers through the interventions outlined above. We think this audit would be easy to replicate in a similar clinical environment. We would recommend that education regarding spiritual needs assessment is incorporated into junior doctors teaching curriculum.