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End-of-life care in acute hospitals: an integrative literature review

journal contribution
posted on 2011-09-01, 00:00 authored by Melissa BloomerMelissa Bloomer, C Moss, W M Cross
Aim. To explore and define the current status of published literature related to end-of-life care in the acute hospital setting.
Background. Chronic illness is now the leading cause of death in developed countries because the population is and the advances in health care delivery. In Australia, two-third of people with chronic illness who die is inpatient in an acute hospital. Whilst most of the attention regarding end-of-life care and dying has focused on palliative care settings, there is a need to consider those dying outside of specialist palliative care settings.
Design. Integrative literature review.
Methods. Using an integrative approach, electronic searches of selected databases were undertaken, using comprehensive search terms. Secondary sources were also identified through the reference lists of retrieved literature.
Results. The literature review identified a lack of high-quality scientific evidence to direct end-of-life care as delivered in the acute (non-palliative care) sector. From the literature available, five core themes/issues were generated to reflect the literature.
Conclusions. There is a need for research to investigate end-of-life care in the acute hospital setting. Care pathways are in use to varying degrees without validation, but implementation alone does not ensure quality end-of-life care. Cultural factors can impede/impact practice and the ability of clinicians to recognise ‘active dying’ has been shown to be problematic, delaying the transition to end-of-life care.
Relevance to clinical practice. Given that the majority of deaths in Australia occur in acute hospital settings, clinicians should be delivering expert life-sustaining acute care and also quality end-of-life care.

History

Journal

Journal of nursing and healthcare of chronic illness

Volume

3

Issue

3

Pagination

165 - 173

Publisher

Wiley-Blackwell

Location

Hoboken, N.J.

ISSN

1752-9816

eISSN

1752-9824

Language

eng

Publication classification

C Journal article; C1.1 Refereed article in a scholarly journal

Copyright notice

2011, Blackwell

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