Abstract
Patient death in critical care is not uncommon. Rather, the provision of end-of-life care is a core feature of critical care nursing, yet not all nurses feel adequately prepared for their role in the provision of end-of-life care. For this reason, the Australian College of Critical Care Nurses (ACCCN) supported the development of a Position Statement to provide nurses with clear practice recommendations to guide the provision of end-of-life care, which reflect the most relevant evidence and information associated with end-of-life care for adult patients in Australian critical care settings. A systematic literature search was conducted between June and July, 2020 in CINAHL Complete, Medline, and EMBASE databases to locate research evidence related to key elements of end-of-life care in critical care. Preference was given to the most recent Australian or Australasian research evidence, where available. Once the practice recommendations were drafted in accordance with the research evidence, a clinical expert review panel was established. The panel comprised clinically active ACCCN members with at least 12 months of clinical experience. The clinical expert review panel participated in an eDelphi process to provide face validity for practice recommendations and a subsequent online meeting to suggest additional refinements and ensure the final practice recommendations were meaningful and practical for critical care nursing practice in Australia. ACCCN Board members also provided independent review of the Position Statement. This Position Statement is intended to provide practical guidance to critical care nurses in the provision of adult end-of-life care in Australian critical care settings.
Highlights
Death in critical care is not uncommon.[1]
Given not all nurses are adequately prepared for their role in providing end-of-life care,[4,5] clear practice recommendations are essential to guiding care
A literature search was conducted between June and July, 2020 in CINAHL Complete, Medline, and EMBASE to locate research evidence related to multiple key elements of end-of-life care in critical care
Summary
Death in critical care is not uncommon.[1]. The provision of endof-life care is a core feature of critical care nursing.[2]. Specific practice recommendations to support the facilitation of high-quality end-of-life care. M.J. Bloomer et al / Australian Critical Care xxx (xxxx) xxx limb exercises, and pharmacological management; 2 organ donation criteria and processes and supports for donor families;[9] culturally sensitive communication and care;[4,5,10] the nature and scope of bereavement support measures for family;11e13 nurse selfcare;[14,15] and debriefing.[7] In addition to theoretical education, opportunities for clinical support at the bedside and for nurses to learn through mentoring, formal and informal role modelling,[6,16,17] and supported clinical exposure to end-of-life care situations at a pace commensurate with the nurse's individual readiness,[18] are essential
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