Effectiveness of supporting intensive care units on implementing the guideline ‘End‐of‐life care in the intensive care unit, nursing care’: a cluster randomized controlled trial

Noome, Marijke; Leeuwen, Evert van; Vloet, Lilian

doi:10.1111/jan.13219

Cited by 18 publications

(51 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Communication related to language difficulties ( p = 0.008) and insufficient training in pain and anxiety recognition ( p = 0.001) were identified as barriers to providing EOL reported by nurses. *Difficulty communicating due to language barriers *Lack of advance directives *Inadequate care goals *Inadequate training in recognition of pain and anxiety *Patient’s inability to participate in care goals Moderate- High Noome, M. [ 36 ] 2016/Netherlands To examine the effectiveness of supporting intensive care units in implementing the guidelines Nurses ( n = 153) Intervention group Nurses ( n = 112) Control group Family ( n = 18) intervention group Family ( n = 15) control group RCT intervention group Results showed that the intervention group followed the guidelines in most aspects more closely than the control group. Families reported that the intervention group showed a markedly higher level of patient care and general nursing care in comparison to the control group.…”

Section: Resultsmentioning

confidence: 99%

“…- Simultaneous requirement to care for other patients while staff work with patients’ palliative need [ 32 ]. - Lack of time to develop and implement strategies [ 36 ]. - Lack of training and education as a result of time and resource constraints [ 19 , 41 ].…”

Section: Resultsmentioning

confidence: 99%

“…- Insufficient standardization of care [ 25 ] and the presence of procedural difficulties [ 32 ]. - Strong leadership and management team support (supportive factors) [ 36 ]. - Guideline recommendations regarding both direct care for palliative patients and palliative care decisions [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…- Trial and error are useful ways to learn from nurses’ experiences [ 19 ]. - Education and professional support while implementing improvements to guidelines [ 36 ]. Multidisciplinary team involvement - Lack of nursing staff involvement in palliative care decision making [ 28 , 29 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Factors influencing the integration of a palliative approach in intensive care units: a systematic mixed-methods review

et al. 2020

View full text Add to dashboard Cite

Background While a palliative approach is generally perceived to be an integral part of the intensive care unit (ICU), the provision of palliative care in this setting is challenging. This review aims to identify factors (barriers and facilitators) influencing a palliative approach in intensive care settings, as perceived by health care professionals. Method A systematic mixed-methods review was conducted. Multiple electronic databases were used, and the following search terms were utilized: implementation, palliative care, and intensive care unit. In total, 1843 articles were screened, of which 24 met the research inclusion/exclusion criteria. A thematic synthesis method was used for both qualitative and quantitative studies. Results Four key prerequisite factors were identified: (a) organizational structure in facilitating policies, unappropriated resources, multi-disciplinary team involvement, and knowledge and skills; (b) work environment, including physical and psychosocial factors; (c) interpersonal factors/barriers, including family and patients’ involvement in communication and participation; and (d) decision-making, e.g., decision and transition, goal conflict, multidisciplinary team communication, and prognostication. Conclusion Factors hindering the integration of a palliative approach in an intensive care context constitute a complex interplay among organizational structure, the care environment and clinicians’ perceptions and attitudes. While patient and family involvement was identified as an important facilitator of palliative care, it was also recognized as a barrier for clinicians due to challenges in shared goal setting and communication.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Factors influencing the integration of a palliative approach in intensive care units: a systematic mixed-methods review

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The integration of bereavement care into the support services offered to relatives of intensive care unit (ICU) patients has been described and endorsed by national and international ICU societies [1][2][3][4]. When a patient is approaching death in the ICU, relatives need to make a rapid transition from focusing on the recovery of their beloved one to preparing for their unavoidable death.…”

Section: Bereavement In the Intensive Care Unitmentioning

confidence: 99%

Developing and testing a nurse-led intervention to support bereavement in relatives in the intensive care (BRIC study): a protocol of a pre-post intervention study

et al. 2020

View full text Add to dashboard Cite

Background: When a patient is approaching death in the intensive care unit (ICU), patients' relatives must make a rapid transition from focusing on their beloved one's recovery to preparation for their unavoidable death. Bereaved relatives may develop complicated grief as a consequence of this burdensome situation; however, little is known about appropriate options in quality care supporting bereaved relatives and the prevalence and predictors of complicated grief in bereaved relatives of deceased ICU patients in the Netherlands. The aim of this study is to develop and implement a multicomponent bereavement support intervention for relatives of deceased ICU patients and to evaluate the effectiveness of this intervention on complicated grief, anxiety, depression and posttraumatic stress in bereaved relatives. Methods: The study will use a cross-sectional pre-post design in a 38-bed ICU in a university hospital in the Netherlands. Cohort 1 includes all reported first and second contact persons of patients who died in the ICU in 2018, which will serve as a pre-intervention baseline measurement. Based on existing policies, facilities and evidence-based practices, a nurse-led intervention will be developed and implemented during the study period. This intervention is expected to use 1) communication strategies, 2) materials to make a keepsake, and 3) a nurseled follow-up service. Cohort 2, including all bereaved relatives in the ICU from October 2019 until March 2020, will serve as a post-intervention follow-up measurement. Both cohorts will be performed in study samples of 200 relatives per group, all participants will be invited to complete questionnaires measuring complicated grief, anxiety, depression and posttraumatic stress. Differences between the baseline and follow-up measurements will be calculated and adjusted using regression analyses. Exploratory subgroup analyses (e.g., gender, ethnicity, risk profiles, relationship with patient, length of stay) and exploratory dose response analyses will be conducted.

show abstract

Tailor Implementation Strategies

2021

Knowledge Translation in Nursing and Healthcare

View full text Add to dashboard Cite

Effectiveness of supporting intensive care units on implementing the guideline ‘End‐of‐life care in the intensive care unit, nursing care’: a cluster randomized controlled trial

Abstract: The increase in adherence to the guidelines and the significantly higher satisfaction of family in the intervention group indicate that the supportive programme had a more positive effect.

Cited by 18 publications

References 19 publications

Factors influencing the integration of a palliative approach in intensive care units: a systematic mixed-methods review

Factors influencing the integration of a palliative approach in intensive care units: a systematic mixed-methods review

Developing and testing a nurse-led intervention to support bereavement in relatives in the intensive care (BRIC study): a protocol of a pre-post intervention study

Tailor Implementation Strategies

Contact Info

Product

Resources

About