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Registration Number: {{org_field_registration_no}}

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Verification of Expected Deaths by Registered Nurses Policy

1. Purpose

The purpose of this policy is to establish clear guidelines for the verification of expected deaths by registered nurses within {{org_field_name}}, ensuring compliance with the latest Care Inspectorate Wales (CIW) regulations, the Regulation and Inspection of Social Care (Wales) Act 2016, and best practice guidelines from professional nursing and healthcare bodies. This policy aims to provide a structured approach to verifying expected deaths in a dignified, lawful, and sensitive manner, ensuring the needs of residents, families, and staff are met while maintaining regulatory compliance.

2. Scope

This policy applies to all registered nurses employed at {{org_field_name}} who have received appropriate training in the verification of expected death. It outlines the criteria, legal requirements, documentation processes, and responsibilities involved in verifying an expected death. The policy applies to all residents receiving palliative or end-of-life care for whom an expected death has been anticipated and documented in their care plan.

3. Related Policies

This policy should be read in conjunction with:

• CHW38 – End of Life and Palliative Care Policy: Ensuring dignified care in the final stages of life.
• CHW11 – Safe Care and Treatment Policy: Supporting clinical governance in resident care.
• CHW36 – Communication and Engagement with Service Users and Families Policy: Ensuring effective communication with families and carers.
• CHW25 – Notification of Other Incidents Policy: Outlining reporting requirements following a death.
• CHW18 – Risk Management and Assessment Policy: Managing risk and ensuring appropriate responses to expected deaths.

4. Policy Statement

{{org_field_name}} is committed to ensuring that the verification of expected deaths by registered nurses is conducted in a professional, compassionate, and legally compliant manner. Our approach is designed to provide reassurance to families, ensure respect and dignity for the deceased, and maintain accurate records for regulatory compliance. This policy supports timely and appropriate verification while working in collaboration with general practitioners (GPs) and other healthcare professionals.

5. Definition of Expected Death

An expected death is one that is anticipated due to a known, irreversible medical condition where the resident is receiving palliative or end-of-life care. Verification of an expected death does not replace the formal certification of death, which must be completed by a medical practitioner.

6. Eligibility Criteria for Nurse Verification of Death

A registered nurse may verify an expected death if:

• The resident has an advanced care plan stating that their death is expected.
• A GP has documented confirmation that the death is expected.
• There are no suspicious or unexpected circumstances surrounding the death.
• The nurse has received formal training in verification of expected deaths.
• The death does not require coroner involvement (e.g., unexplained, unexpected, or violent deaths).

7. Procedure for Verifying an Expected Death

The following steps must be followed when verifying an expected death:

1. Preparation and Initial Assessment
   • Ensure the resident’s care plan includes documented evidence of an expected death.
   • Confirm with the GP that the resident was on an end-of-life pathway.
   • Provide immediate support to any family members present.
2. Clinical Examination
   • Conduct a thorough examination to confirm the absence of vital signs, including:
     • No response to verbal or physical stimuli.
     • Absence of a central pulse for at least one minute.
     • Absence of heart sounds using a stethoscope.
     • No spontaneous respiration for at least one minute.
     • Fixed and dilated pupils unresponsive to light.
   • Re-examine after five minutes to confirm findings.
3. Documentation and Record-Keeping
   • Complete the Verification of Expected Death Form, recording:
     • Date, time, and location of death.
     • Full name and DOB of the deceased.
     • Clinical findings and time of verification.
     • Names of staff present.
   • Notify the GP to complete the death certification.
   • Ensure all records are securely stored and meet GDPR requirements.
4. Family Communication and Support
   • Provide compassionate communication with the resident’s family.
   • Offer bereavement support and guidance on next steps, including funeral arrangements.
   • Provide contact details for external bereavement support services if needed.
5. Notification and Reporting
   • Notify the GP and update the resident’s medical records.
   • Inform relevant senior staff members and care teams.
   • Report the death to CIW and any other required regulatory bodies as per statutory guidelines.

8. Managing Verification of Death Efficiently

To ensure a professional and efficient approach to verification, {{org_field_name}} implements the following strategies:

• Comprehensive Staff Training: All registered nurses receive formal training in death verification.
• Clear Documentation Standards: Standardised verification forms and clear record-keeping practices.
• Bereavement Support Pathways: Ensuring families are supported through dedicated guidance and resources.
• Rapid Communication Protocols: Efficient notification processes to GPs, families, and regulatory bodies.
• Regular Policy Reviews: Ensuring alignment with the latest CIW regulations and best practices.

9. Responsibilities

• Registered Nurses: Responsible for carrying out verification in line with this policy, maintaining professionalism, and ensuring compassionate communication with families.
• Registered Manager: Ensures policy compliance, provides oversight, and facilitates training.
• GPs and Healthcare Professionals: Provide medical certification of death and collaborate with nursing staff.
• HR and Training Team: Ensures all relevant staff receive appropriate training in death verification.

10. Compliance with CIW Regulations

This policy ensures compliance with CIW regulations by:

• Providing a structured approach to the verification of expected deaths.
• Maintaining dignity and respect for residents at end-of-life.
• Ensuring proper documentation to support regulatory audits and inspections.
• Facilitating appropriate reporting to healthcare providers and regulatory authorities.
• Supporting a well-trained workforce to handle verification professionally and compassionately.

11. Policy Review

This policy will be reviewed annually or updated in response to changes in legislation, CIW requirements, or professional guidance. Any amendments will be communicated to all staff to ensure continued compliance and high standards of care.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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