Policy briefing

Guidance for nurses on verifying expected death

Hospice UK guidance supports nurses in verifying the expected death of an adult

Updated guidance developed by Hospice UK supports nurses in verifying the expected death of an adult

Picture: iStock

Essential facts

Experienced designated registered nurses have the authority to confirm death, notify relatives and arrange for last offices and the removal of the body to a mortuary or funeral director, according to the RCN.

However, nurses must check their employers’ policy on this. Death can be verified by nurses when several conditions are met, including that the death is expected, is not suspicious and documentation relating to ‘do not attempt cardiopulmonary resuscitation’ has been signed in line with current guidance.

What’s new?

Updated guidance has been published to support experienced nurses to make a timely verification of an expected adult death.

The guideline and competency assessment tool will enable staff to care appropriately for the deceased, in line with local policy, and minimise distress for families and carers after a death at any time of the day.

Developed by the charity Hospice UK, the guidance is in line with national recommendations on person- and family-centred care. It aims to ensure that death is dealt with in line with the law, in a timely, sensitive and caring manner and in a way that respects the dignity, religious and cultural needs of the patient and family.

Timely verification – within one hour in a hospital setting and within four hours in a community setting – is an important stage in the grieving process for relatives and carers and also a key time for support, the document says.

Implications for nurses

  • Nurses must understand guidance and must have received appropriate training and be deemed competent to verify death.
  • The nurse must inform a doctor of a death using agreed local systems, and document the date and time this was carried out in the clinical record.
  • Time spent on assessing cessation of central pulse, cessation of heart sounds and cessation of respiratory effort should total five minutes.
  • The nurse carrying out the procedure must notify a funeral director or mortuary of any infections, radioactive implants, implantable devices and whether an implantable cardiodefibrillator is still active.
  • The verifying nurse has the right to refuse to verify death and to request the attendance of the responsible doctor and police if there is anything unusual.

Expert comment

Marie Cooper is practice development lead at Hospice UK

‘Historically, doctors have carried out verification of death. But now, particularly in the community and in care homes, nursing staff are increasingly carrying out verification, and we see demand for this rising.

‘We want to support nurses to carry out this important component of care after death, as we see it as core to good-quality care for the dying and their relatives. Some relatives can find it distressing to have a long wait for a doctor to verify death.

‘Verification of death carries significant responsibilities, and some nurses are understandably anxious about this. This guidance is a resource to be used by nurses and employers to build the capacity and capability of the registered nurse workforce across all care settings.’

Erin Dean is a health journalist

Further information

This article is for subscribers only