Download the Care After Death: Registered Nurse Verification of Expected Adult Death (RNVoEAD) Guidance (5th edition, updated June 2022); and Care After Death (4th edition, updated July 2022).
The aim of this guidance is to provide a framework for the timely verification of expected adult deaths by experienced (assessed as competent), registered nurses (RN).
It is anticipated that local areas will develop their policies based on the guidance, but sensitised to the local area, enabling staff to care appropriately for the deceased, supporting and minimising distress for families and carers at any time of the day, night, or week. This guidance has been developed in line with the person and family centred care recommended in national documents.
Timely verification – within one hour in a hospital setting and within four hours in a community setting – is supportive to bereaved families, and is necessary prior to the deceased being moved to either the mortuary or funeral directors, We recognise that this timeframe may not be achievable under current sustained COVID-19 infection circumstances, in these cases it may be appropriate to offer guidance to families regarding the positioning of the deceased person and the maintenance of a cool environment.
Families should be advised that there might be a difference between the time of the last breath and the official time of death.
This guidance ensures that the death is dealt with:
in line with the law and coroner requirements (see Appendix 1)
in a timely, sensitive, and caring manner
respecting the dignity, religious and cultural needs of the patient and family members as far as is practicable
ensuring the health and safety of others, e.g. from infectious illness including COVID-19, radioactive implants, and implantable devices
A competency assessment tool (see Appendix 2) accompanies this guidance for RNs to demonstrate their practical skills, knowledge and understanding for verifying an expected adult death. RNs already competent in verification of an expected adult death are not expected to repeat the competency assessment, rather to familiarise themselves with the changes within this guidance and adopt the changes into their practice.
There has been an e-learning module for the Registered Nurse Verification of Expected Adult Death developed by e-Learning for Health and this may provide a useful resource. Local areas may want to adopt a pragmatic approach to training. If the RN does not feel confident after completing training, they could undertake the verification of death with the remote support and guidance of a more experienced colleague.
This guidance may be used to inform training for other registered healthcare professionals who are regulated by a professional body who, under statutory regulation, are recognised by the Professional Standards Authority.
Our position remains that we only recommend nurses who are included on the NMC register to undertake this role as we strongly believe that the wraparound care required at point of death, including the discontinuation and safe disposal of medication and care of the bereaved, requires this level of knowledge and skill. We do, however, recognise that this is guidance and our expectation is that organisations will take this guidance and amend for their local policy, education and training needs.
We continue to support and promote the inclusion of verification of death in the pre-registration training of Registered Nurses and Nursing Associates in line with the relevant competencies, and the continued uptake of this aspect of patient and family care by registered nurses already in clinical practice.
We also look forward to new working with the Academy of Medical Royal Colleges Task and Finish group to revise the Code of Practice for the Diagnosis and Confirmation of Death and will update these two guidance documents again once there has been progress.
We recommend that commissioners of education and services consider the importance of verification of expected death and care after death in ensuring compassionate care for those who have died and those who are bereaved.
