Introduction: In a home care setting as well as in palliative care units the MS 26 syringe driver is a frequent used aid for the symptomatic treatment. Nevertheless there does not exist a standardised procedure for installing such a syringe driver. No more less is known about the actual use and the criteria needed to attain an excellent quality of care. This research intends to observe and to describe the practical implementation of a syringe driver.
Methodology: This observational, describing study is based on the method of participating observation. A checklist is created by means of the literature, the directions for use and the advices of the palliative care teams. Two experts comment this checklist. Two medical students execute the observation. There is also attention for the indications to install a syringe driver, the medication used and the referring caregiver.
Results: 22 patients are included, 11 men and 11 women (mean age: 73.5). 20 of them have a malignant disease. For 17 a doctor is the referring caregiver. The 3 most important indications are: insufficient pain control (n=11), nausea and vomiting (n=8) and the need of a continuous and well-dosed medication (n=4). In almost all the cases nurses install the syringe driver. In less of one half of the cases soap and towel are not used omitting washing and disinfection of the hands. In only 4 cases morphine alone is used, in 11 patients morphine is given in combination with other medication like antiemetics and corticosteroids, in 7 patients no morphine is administered. The procedure of installing the syringe driver took 21 minutes. The care after the installation in a palliative care unit happens systematically by the team; home care failed in not giving information about V.A.S scoring of the pain and about the administration of a bolus.
Conclusion: The problems of installing a syringe driver in a palliative care setting are mainly about hygiene and the delivery of information.