Publication Date

Spring 5-2017

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Diane Katsma

Second Advisor

Robert C. Morehead

Third Advisor

Cary Z. Joel

Keywords

End-of-life, Intensive Care Unit, ICU, Pain, Palliative care

Abstract

Today, one in five hospital deaths happens in the intensive care unit with the expectation of twice as many by 2030. Increasing, mortality has triggered a growing attention to end-of-life (EOL) care in the ICU. However, the lack of coveted EOL and palliative care skills creates a challenge for ICU nurses. The aim of this study was to assess the current practices of EOL care in the ICU. In this quantitative research, a retrospective chart review method was employed to analyze the collected data from a population 60 EOL patients who died in the ICU of a Southern California hospital. The results highlight the inadequate treatment of EOL discomforts. No patients received palliative care or POLST designation, and only one patient received hospice care. Also, the highest mortality happened within the first 6 days of the hospital stay, indicating the time sensitive nature of ICU admissions. Therefore, early planning of the comfort care for end-of-life patient and better communication with the inter-professional team is recommended.

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