What are the challenges for nurses when providing end-of-life care in intensive care units?

Abstract

Aim: this literature review aimed to explore qualitative studies in which nurses discussed the challenges they face when delivering end-of-life care in intensive care units (ICUs). Analysis and discussion of the studies' findings aimed to contribute to the current evidence base surrounding the subject.

Method: a systematic search of academic databases was conducted to source relevant studies. An inductive process using grounded theory was undertaken to elicit suitable themes to address the review question.

Findings: six relevant studies were identified with four main themes emerging from analysis. The themes were a lack of nurse involvement in end-of-life care decision-making, a lack of nursing knowledge in providing end-of-life care, the dilemma of prioritising care between the patient and family, and the nature of providing end-of-life care within an ICU environment.

Conclusion: the provision of end-of-life care in ICUs requires nurses to be involved in interdisciplinary communication. ICU-specific end-of-life care education, training and guidelines need to be implemented to ensure patients receive high-quality, patient-centred care.

Keywords: Critical care; End-of-life care; Intensive care; Nursing research; Terminal care.