161 Carer administration of subcutaneous medications at home

<h3>Background</h3> Carers and patients are more empowered than ever to be involved in end of life care at home. To facilitate prompt resolution of symptoms, it is important that we standardise education and practice of carers and patients who can and want to be able to administer anticipatory subcutaneous medications independently and support them appropriately to manage symptoms at the end of life. At St Luke’s Hospice, Harrow, I created a policy document on Carer Administration of Subcutaneous Medication at Home to form clear guidelines for professionals across the three services (inpatient unit, community and telephone helpline) to be able support patients and families appropriately and robustly. <h3>Method</h3> An initial literature review was done of existing policies and frameworks around carer administration of subcutaneous medications. Alongside UK examples of good practice, examples were drawn from the USA and Australia where practice is more widespread. A consultation process was undertaken with stakeholders from each of the hospice services to ensure that the policy was workable and there was consensus on proposed best practice for our organisation. Review processes were put in place and clear lines of communication established between hospice services and relevant external services including district nursing to ensure safe implementation. <h3>Results</h3> Feedback from staff at all levels of the organisation relayed the usefulness of a standardised approach to carer education, agreement implementation and ongoing review of patients. This allowed increased confidence in care being delivered and reduction of perceived risk. <h3>Conclusions</h3> Implementing a standard operating procedure for carer administration of subcutaneous medicines improved professional confidence in empowering patients and their loved ones to manage symptoms better at home. Allowing carers and patients to administer subcutaneous medications independently should be considered more widely within UK community palliative medicine practice. A standardised and collaborative approach can minimise risk significantly and increase patient comfort.