Last Departure: A nurse-led innovation to standardize and humanize end-of-life care in oncology.

Abstract

338 Background: End-of-life (EOL) care is frequently inconsistent across clinical settings, resulting in distress for families and increased emotional burden on staff. To address these system-level gaps, the Palliative Care nursing team developed Last Departure , a structured and culturally responsive EOL protocol designed to enhance dignity, communication, and workflow reliability. Methods: A prospective implementation was conducted in a tertiary cancer center. The protocol integrated five components: standardized environment preparation, anticipatory family communication, clear role delineation, dignity-preserving postmortem care, and structured staff debriefing. Outcomes included family satisfaction, staff distress, adherence to workflow standards, and delays in essential EOL procedures. PPS distribution for 2025 was reviewed to contextualize terminal-care needs. Results: A total of 80 patients received the Last Departure intervention in 2025. Family satisfaction was exceptionally high (4.92/5). Staff distress decreased by 32%, adherence to postmortem standards increased from 58% to 91%, and procedural delays decreased by 45%. PPS data from 2025 showed 424 patients with PPS 10–30% and 80 PPS 0% deaths (inpatient), underscoring the need for a reliable and standardized EOL pathway. Families reported greater preparedness and emotional support, while staff described improved teamwork and reduced moral distress. Conclusions: Last Departure is a feasible, low-cost, and scalable nurse-led innovation that enhances the consistency, humanity, and cultural sensitivity of EOL care in oncology. It represents a practical model that can be adopted widely across cancer and palliative care settings.