End of life management of adult patients in an Australian metropolitan intensive care unit : a retrospective observational study

Bloomer, Melissa J., Tiruvoipati, Ravindranath, Tsiripillis, Michael and Botha, John A. 2010, End of life management of adult patients in an Australian metropolitan intensive care unit : a retrospective observational study, Australian critical care, vol. 23, no. 1, pp. 13-19, doi: 10.1016/j.aucc.2009.10.002.

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Title End of life management of adult patients in an Australian metropolitan intensive care unit : a retrospective observational study
Author(s) Bloomer, Melissa J.ORCID iD for Bloomer, Melissa J. orcid.org/0000-0003-1170-3951
Tiruvoipati, Ravindranath
Tsiripillis, Michael
Botha, John A.
Journal name Australian critical care
Volume number 23
Issue number 1
Start page 13
End page 19
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2010-02
ISSN 1036-7314
1878-1721
Keyword(s) intensive care
death
end of life
communication
Summary Background Death in the intensive care unit is often predictable. End of life management is often discussed and initiated when futility of care appears evident. Respect for patients wishes, dignity in death, and family involvement in the decision-making process is optimal. This goal may often be elusive. Purpose Our purpose was to review the end of life processes and family involvement within our Unit. Methods We conducted a chart audit of all deaths in our 10 bed Unit over a 12-month period, reviewing patient demographics, diagnosis on admission, patient acuity, expectation of death and not-for-resuscitation status. Discussions with the family, treatments withheld and withdrawn and extubation practices were documented. The presence of family or next-of-kin at the time of death, the time to death after withdrawal of therapy and family concerns were recorded. Results There were 70 patients with a mean age of 69 years. Death was expected in 60 patients (86%) and not-for-resuscitation was documented in 58 cases (85%). Family discussions were held in 63 cases (90%) and treatment was withdrawn in 34 deaths (49%). After withdrawal of therapies, 31 patients (44%) died within 6 h. Ventilatory support was withdrawn in 24 cases (36%). Family members were present at the time of death in 46 cases (66%). Family concerns were documented about the end of life care in only 1 case (1.4%). Conclusion Our data suggests that death in our Unit was often predictable and that end of life management was a consultative process.
Language eng
DOI 10.1016/j.aucc.2009.10.002
Field of Research 110310 Intensive Care
111003 Clinical Nursing: Secondary (Acute Care)
1110 Nursing
Socio Economic Objective 920211 Palliative Care
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2009, Australian College of Critical Care Nurses
Persistent URL http://hdl.handle.net/10536/DRO/DU:30081920

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