Healthcare professionals' values about and experience with facilitating end-of-life care in the adult intensive care unit

Intensive Crit Care Nurs. 2021 Aug:65:103057. doi: 10.1016/j.iccn.2021.103057. Epub 2021 Apr 20.

Abstract

Objectives: To evaluate values and experience with facilitating end-of-life care among intensive care professionals (registered nurses, medical practitioners and social workers) to determine perceived education and support needs.

Research design: Using a cross-sectional study design, 96 professionals completed a survey on knowledge, preparedness, patient and family preferences, organisational culture, resources, palliative values, emotional support, and care planning in providing end-of-life care.

Setting: General adult intensive care unit at a tertiary referral hospital.

Results: Compared to registered nurses, medical practitioners reported lower emotional and instrumental support after a death, including colleagues asking if OK (p = 0.02), lower availability of counselling services (p = 0.01), perceived insufficient time to spend with families (p = 0.01), less in-service education for end-of-life topics (p = 0.002) and symptom management (p = 0.02). Registered nurses reported lower scores related to knowing what to say to the family in end-of-life care scenarios (p = 0.01).

Conclusion: Findings inform strategies for practice development to prepare and support healthcare professionals to provide end-of-life care in the intensive care setting. Professionals reporting similar palliative care values and inclusion of patient and family preferences in care planning is an important foundation for planning interprofessional education and support with opportunities for professionals to share experiences and strengths.

Keywords: Bereavement; Critical care; End of life; Intensive care units; Needs assessment; Nurses; Palliative care; Physicians; Terminal care.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Humans
  • Intensive Care Units
  • Qualitative Research
  • Terminal Care*