Introduction The Liverpool Care Pathway (LCP) has been effective in bringing a framework to the provision of care for the dying patient. Over the last 10 years the LCP has been adapted to assist in clinical areas that were not traditionally thought of as providing palliative care. In 2005 it was adapted and developed to reflect the specialised and unique environment of the Emergency Department (ED).

Methods This qualitative study collated the response to an anonymous web based questionnaire and focus group discussions with ED nursing staff. The groups facilitated discussion on day to day nursing perception and satisfaction with the LCP. The results were analysed using thematic analysis.

Results Common themes were identified in the questionnaire's results and focus groups. The staff believe that the adapted LCP provides a complete framework for delivery of care to the dying patient. They felt able to utilise their clinical judgment and that their opinions were valued within the LCP. Following implementation the staff felt a closer working relationship when supporting and communicating with the patient and their family.

Conclusion Nursing satisfaction improved with the provision of care the LCP enabled them to provide. The development of a specifically tailored pathway was described as being enabling. The focus groups also felt that the knowledge base was good, however further updates and formalised training would increase the overall understanding within the department. This adapted LCP is regularly reviewed and updated to ensure the highest level of patient care, resulting in staff having the opportunity to influence the care they are providing. The feedback and review allows continual development to insure it meets the needs of the busy environment of Emergency Medicine (EM). This regular review and feedback will allow the model of the LCP in EM to be transferred to other ED's throughout the UK.