Promoting Excellence : Palliative Care Worksheet - University of Pennsylvania School of Nursing

University of Pennsylvania School of Nursing/Genesis Eldercare: Palliative Care Worksheet

Used to determine circumstances surrounding last month of life including presence of symptoms, interventions used, and resources utilized for patients enrolled in ElderCare.

Evaluation Tools — Clinical Quality

University of Pennsylvania
School of Nursing
Hartford Center of Geriatrics
420 Guardian Drive
Philadelphia, PA 19104-6096

Neville Strumpf, PhD,RN
[email protected]

How the grantee used this instrument:
Completed by staff 24 - 48 hours after the death of each nursing home resident enrolled in ElderCare.

palliative care, care plan review, chart audit, chart review, post death review

To use this tool:
You may print and copy this tool for your own use from the website. Please credit source.

Developed by the project team for this project.

To view this tool:
Left click on the download link to view the PDF document in your Web browser. Right-click on the download link to save the document to your computer.
pdf PDF 22 KB / 2 pages (Viewing PDF files requires downloading and installation of the free Adobe Acrobat Reader.)

Posted October 2004

University of Pennsylvania overview page

# UP08, type:clinical_quality

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit for more resources.

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