Care after death: practical procedures
What
to do after a patient has died, out of the ward area
in hospital
The site co-ordinator and mortuary can be contacted for advice. It may be more appropriate and dignified for the deceased person to be transferred directly to the mortuary viewing room to perform personal cares.
Personal cares after death
The most up-to-date flow chart to guide practice is available in the blue ‘Care after Death’ box on every adult ward or on the intranet either on PolicyStat or: https://nhs.sharepoint.com/sites/RCD_PalliativeandEndofLifeCare
No treatments should be stopped until the person has been verified by a doctor or competently trained registered nurse / advanced clinical practitioner.
PROCEDURE FOR COMPLETING PERSONAL CARE AFTER DEATH IN HOSPITAL SETTING
It is best practice to do this with two people, one of whom needs to be a registered nurse or a suitably trained person. If the patient has been referred to the Coroner, please leave all devices insitu e.g. catheters, drains, cannulas, syringe driver, NG tube, etc.
PPE REQUIREMENTS: FOLLOW HDFT INFECTION PREVENTION POLICY and REFER to HDFT PROCEDURE 029 FOR HANDLING BODIES AFTER DEATH
Lay the deceased person on their back
Straighten their limbs with their arms lying by their sides
Remove pillows
Close the eyes by applying light pressure for 30 seconds
*If fails, explain to family/carers a funeral director will resolve the issue*
*If donating cornea or eyes, close eyes with gauze soaked in normal saline*
Clean mouth to remove debris and secretions
Suction excess fluid from oral cavity or tracheostomy site
Clean and replace dentures as soon as possible after death
*If cannot replace send to mortuary with the body in labelled receptacle*
Support the jaw by placing pillow or rolled up towel underneath
*remove it before family/carers view*
*Do not bind with bandages*
Tidy hair
*In preferred style if known to guide funeral director*
*Do not shave – the funeral director will undertake this if required*
Remove syringe driver and Saf-T-Intima (if applicable)
Remove urinary catheter (if applicable)
Cover stoma with clean bag (if applicable)
Remove drains (if applicable) and cover leaking wounds /drain sites with clean, absorbent and occlusive dressing(s)
*Leave any stitches / clips intact*
Disconnect IV line and remove cannula (if applicable)
Disconnect feed and remove NG tube (if applicable)
Wash and dress the deceased person unless requested not to do for religious, cultural reasons or family preferences.
Consider whether family wish to be involved in personal care of deceased
Wash and dress the deceased person unless requested not to do for religious, cultural reasons or family preferences.
Dress in hospital gown /shroud, own nightwear or clothes if chosen by family
*NO person should be left naked*
*note: The funeral director will dress them in their own clothes if nightwear/gown*
Consider whether family wish to be involved in personal care of deceased Dress in hospital gown /shroud, own nightwear or clothes if chosen by family *NO person should be left naked*
Remove jewellery – return to family, send to General Office / put in Safe
*note: The funeral director will dress them in their own clothes if nightwear/gown*
*If family request for jewellery to be left on – secure with tape and document clearly* Return these immediately to any family present or follow guidance on SOP Care after Death
Remove jewellery – return to family, send to General Office / put in Safe
*If family request for jewellery to be left on – secure with tape and document clearly* Return these immediately to any family present or follow guidance on SOP Care after Death
The deceased person requires attachment of 2 ID name bands: one on wrist and one on ankle
The deceased person requires attachment of 2 ID name bands: one on wrist and one on ankle
Complete Mortuary Transfer Checklist
*ALL wards must follow SOP Care after Death Care of Property & Valuables (Blue Box or PolicyStat)*
Complete Mortuary Transfer Checklist
Request porter
*ALL wards must follow SOP Care after Death Care of Property & Valuables (Blue Box or PolicyStat)*
Note: if families are requesting to accompany the deceased to the mortuary refer to Policystat Guidance: Allowing Relatives to Accompany a Deceased Patient to the Mortuary via Chapel
Request porter
Complete identification check with porter
Note: if families are requesting to accompany the deceased to the mortuary refer to Policystat Guidance: Allowing Relatives to Accompany a Deceased Patient to the Mortuary via Chapel
*discuss any jewellery left on body*
Complete identification check with porter
Wrap body in sheet, tape lightly
*discuss any jewellery left on body*
Sealed body bags should ALWAYS be used when there is actual or potential leakage of body fluids irrespective of the patient's infectious status
Wrap body in sheet, tape lightly
Sealed body bags should ALWAYS be used when there is actual or potential leakage of body fluids irrespective of the patient's infectious status
Patients known or suspected to be infected with a notifiable infection (refer to HDFT Procedure 029 for Handling Bodies After Death for specific details) must be labelled 'High Risk' or 'Danger of Infection' and placed in a sealed body bag before transporting to the mortuary. The Senior Nurse or Site Coordinator should be consulted and the Infection Prevention and Control Policy / Procedure adhered to.
Patients known or suspected to be infected with a notifiable infection (refer to HDFT Procedure 029 for Handling Bodies After Death for specific details) must be labelled 'High Risk' or 'Danger of Infection' and placed in a sealed body bag before transporting to the mortuary. The Senior Nurse or Site Coordinator should be consulted and the Infection Prevention and Control Policy / Procedure adhered to.
Assist Porter to transfer the patient onto the trolley
Assist Porter to transfer the patient onto the trolley
PLEASE NOTE:
ü Do not tie the penis
PLEASE NOTE:
ü The body may turn purple or pink as blood pools
ü The body will cool after death
ü Do not tie the penis
ü The body will go stiff (rigor mortis) between two to six hours after death
ü The body may turn purple or pink as blood pools
ü You may see muscle twitches or spasms after death
ü The body will cool after death
ü The sphincter relaxes causing incontinence of urine and faeces, you may also hear gas released
ü The body will go stiff (rigor mortis) between two to six hours after death
ü You may hear moaning or groaning noises as muscles relax (including vocal cords) and gas builds up
ü You may see muscle twitches or spasms after death
ü The sphincter relaxes causing incontinence of urine and faeces, you may also hear gas released
ü You may hear moaning or groaning noises as muscles relax (including vocal cords) and gas builds up
This guidance is based on guidance within 'Royal Marsden Manual of Clinical and Cancer Nursing Procedures 10th edition' available on the HDFT intranet: Knowledge and Library Service
This guidance is based on guidance within 'Royal Marsden Manual of Clinical and Cancer Nursing Procedures 10th edition' available on the HDFT intranet: Knowledge and Library Service