Theory into Practice: Withdrawal of Artificial Life Support in the ICU (733)

Abstract

1.Review concise medication order set for physicians to guide withdrawal of life support in ICU.2.Review ICU nurse's intervention and documentation form for withdrawal of life support in the ICU.3.Discuss the process of instituting a formalized program for withdrawal of life support in ICU. I. Background. This presentation portrays a three step process in providing quality end-of-life care in the ICU and summarizes the following interventions; integration into the ICU physician and nursing culture; construction and finalization of a physician medication order set and creation of a nursing intervention/documentation form. Theory was put into practice by an interdisciplinary team comprised of the Palliative Care Consult Team's (PCCT) nurse practitioner and physician, ICU nurse specialist and clinical application's pharmacist and nurse coordinator. We elected a minimalist approach in order to formalize a previously informal practice regarding withdrawal of life support in the ICU. There are many excellent clinical resources in the literature regarding withdrawal of life support in the ICU. We used them to form the foundation of the order set and nursing intervention/documentation form. However, forms alone are not sufficient to support a quality program. The PCCT immersed themselves within the medical and nursing culture of the ICU over a 2-year period using one on one interaction and role modeling. We view this period as the most influential aspect of this venture. II. Aims. Present medication order set and nursing intervention/documentation form to guide withdrawal of life support in the ICU. Discuss pathways the PCCT traveled in order to ensure viability of the medication order set and nursing intervention/documentation form. III. Method/Session Description. Poster/Presentation. IV. Conclusion. Formalization of a medication order set and nursing intervention/documentation form will enable all care providers to facilitate a peaceful death for patients who undergo withdrawal of life support. The forms also foster medical and nursing staff to include social work, chaplains, and the patient's family in all aspects of the withdrawal of care process.