Development of a Clinical Practice Guideline for Palliative Sedation

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Abstract
Palliative sedation is an effective symptom control strategy for patients who suffer from in- tractable symptoms at the end of life. Evidence suggests that the use of this practice varies considerably. In order to minimize variation in the practice of palliative sedation within our health region, we developed a clinical practice guideline (CPG) for the use of palliative se- dation. Using available evidence from the literature, a five step process was employed to de- velop the CPG: (1) a working group was charged with the mandate to develop a draft guide- line; (2) a working definition for palliative sedation was developed; (3) criteria for use of sedation were determined; (4) critical steps to be taken prior to initiation of sedation were de- fined; and (5) the CPG was reviewed by local stakeholders. Feedback from the wider group of stakeholders was used to arrive at the final CPG, which subsequently received approval from the local Medical Advisory Board. The process used to develop the CPG served to de- velop consensus within the local community of palliative care clinicians regarding the prac- tice of palliative sedation. Subsequently, the CPG was used as a tool for educating other health care providers.

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