End-of-life care in the intensive care unit: the perceived barriers, supports, and changes needed

Authors

  • Emir Festic Departments of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL
  • Reetu Grewal Department of Palliative Medicine, Mayo Clinic Florida
  • Jeffrey T. Rabatin Divisions of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, MN
  • Gavin D. Divertie Departments of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL
  • Robert P. Shannon Department of Palliative Medicine, Mayo Clinic Florida
  • Margaret M. Johnson Department of Critical Care Medicine and Division of Pulmonary Medicine, Mayo Clinic Florida

Keywords:

End-of-life care, Intensive care unit, Physicians, Nurses

Abstract

Objective. To identify perceived barriers, supports andchanges needed to improve end-of-life care (EOLC) in theintensive care unit (ICU) and to compare physicians’ perceptionswith those of nurses. Methods. We conducted a surveyof critical care physicians and nurses in an academic medicalcenter via a 3-item survey with open-ended statements regardingthe strongest barriers, supports and changes neededto improve EOLC in ICU. Results. Thirty-four percent of allrespondents identified physicians as the biggest barrier andthirty-three percent recognized nursing staff as the strongestsupport towards optimal EOLC. Improved communicationwas identified by 30% of respondents as the change mostneeded to improve EOLC. No significant differences betweenphysicians and nurses were observed. Conclusions. Criticalcare physicians and nurses identified similar barriers, supportsand the changes most needed to improve EOLC in the ICU.Recognition of physicians as the strongest barrier, and communicationas the change most needed indicate areas for improvement.The finding of nurses as the strongest support for goodEOLC provides the opportunity to strengthen their role in thecare of the dying patient. Further study of these findings willhelp develop strategies to improve EOLC in the ICU.

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Author Biographies

Emir Festic, Departments of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL

Reetu Grewal, Department of Palliative Medicine, Mayo Clinic Florida

Jeffrey T. Rabatin, Divisions of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, MN

Gavin D. Divertie, Departments of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL

Robert P. Shannon, Department of Palliative Medicine, Mayo Clinic Florida

Margaret M. Johnson, Department of Critical Care Medicine and Division of Pulmonary Medicine, Mayo Clinic Florida

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Published

2010-09-25

How to Cite

Festic, E., Grewal, R., Rabatin, J. T., Divertie, G. D., Shannon, R. P., & Johnson, M. M. (2010). End-of-life care in the intensive care unit: the perceived barriers, supports, and changes needed. Acta Medica Academica, 39(2), 150–158. Retrieved from https://www.ama.ba/index.php/ama/article/view/85

Issue

Section

Clinical Science

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