End of life clinician– family communication in ICU : a retrospective clinical study— implications for nursing

Objective
The objective of this study was to identify practice
issues that influence
end of life
communication and
care of patients and families in the intensive care unit
(ICU).
Design
This study used a retrospective observational approach
utilising a medical record review.
Setting
An Australian metropolitan mixed medical/surgical ICU.
Subjects
There
are two parts to this study. The
first part related
to all of the patients who died in the ICU in one
calendar year, a total of 97. The second part of this
study related to a random selection of 25% of these
patients, a total of 24.
Results
This study showed that death in the ICU was often
anticipated, and that whilst communication between
family and medical personnel was evident in the
medical record, the involvement or occurrence of
communication between the nurse and the family was
not recorded, and that nurses were included in only
25% of formal family meetings.
Conclusion
Whilst this study confirmed that death is often
predicted for critically ill patients, and opportunities
for communication with the family or next of kin
assists to achieve consensus on end of life decisions,
the involvement of nurses, as primary care‑givers
is not well represented in the medical record, thus
undermining the importance of the nurses role in
direct patient care that extends to the family in the ICU.