The review of the evidence has shown that the contribution of nursing can be difficult to measure and consequently support nurse staffing ratios. However, there is a growing body of evidence which associates higher number of registered nursing staff to patient ratio relates to improved safety and better outcomes for patients. The challenge for nurses is to produce accurate and meaningful outcome measures for nursing and collect data that accurately reflect the input of nursing on patient outcomes and safety.

This is the first time that moral distress is explored, in a case approach, among relatives, doctors, and nurses intimately involved in end-of-life decisions in intensive care. Dissemination of findings will make a large contribution to international knowledge and understanding in this area and alert healthcare professionals and relatives to an otherwise under-recognized, but potentially detrimental, experience. Findings will inform education, practice, and policy.

No abstract