RESEARCH ARTICLE

Research Article

Long, A. C., Kross, E. K., Engelberg, R. A., Downey, L., Nielsen, E. L., Back, A. L., & Curtis, J. R. (2014). Quality of dying in the ICU: is it worse for patients admitted from the hospital ward compared to those admitted from the emergency department? Intensive care medicine, 40(11), 1688-1697. Web: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350659/

Introduction

Ideally, as people age in most cases they take keen interest, however, optimal eminence of dying as well as death for children and adults who are critically as well as noncritical ill who pass away in hospice care settings depends profoundly on end-of-life care. Therefore, it is evident that in critically ill patients nearly dying, the healthcare providers and relatives’ company compared to non-presence result to positive outcomes and increased patient satisfaction at the time of palliative care.

PICOT QUESTION: In critically ill patients nearly dying, how is the healthcare providers and relatives’ company compared to non-presence result to positive outcomes and increased patient satisfaction at the time of palliative care?

Most patients have relatives who provide some care. However, in cases of elderly and those persons with chronic illness, this form of care can be considerable in scope, strength, and time. Ideally, family cares giving increases security questions in many ways, which are supposed to concern caregivers in entire settings. Recent meta-analyses found that coordination of care, which includes communication among caregivers and caregiver and relatives to the patient, is particularly crucial for the reason that healthcare near death can include many healthcare experts, multi-chronic conditions, and fast developing complex complications with therapeutic and social scopes (Cypress, 2012). According to Long et al. (2014), statistical mean patient age admitted due to critical illness was elderly 70.4 years (with Standard Deviation of 13.9) and 58 percent (n=877) of the patients were male. The majority was non-Hispanic white (77 percent), as well as most were hospitalized directly from home (63 percent) (Long et al., 2014).

According to Long et al. (2014), in the quantitative research done on healthcare providers and patient family, improvements in the provision of pediatric and adult end-of-life care courses are linked with enhanced eminence of dying along with death upshots, 71 percent. On the other hand, challenges to the liberation of this kind of care depressingly impact on quality effects and a diversity of effective strategies are required to trounce those challenges. Identification of problems and seeking important facilitators remain the initial steps in the determination of the way to perk up pediatric and adult hospice care (Long et al., 2014).

Hospice care remains end-of-life care; therefore the aim of care remains to help dying patients to have comfort, peace, and dignity. Healthcare professionals offer medical, psychological, as well as divine help to the patients. However, hospice patients can desire to get home hospice health care or hospice inpatient care. According to Long et al., (2014), hospice healthcare providers work directly with relatives and the patient in the creation of a care plan, which meets the needs (linked to the incurable ill health) of the patient along with family (Long et al., 2014). At the time relatives differ regarding the objective of hospice care, the hospice experts are placed in a hard position.

However, in some cases, the quiet, passive and frequently grieving relatives may perhaps remain quiet at the same time as a dominant family aggressor conquest. In a state that families have articulated their requirement to be knowledgeable regarding the healthcare being provided to their family, albeit dominant relatives had barred them as of the process without the patient’s knowledge. It remains uneasy for definite relatives to protest or protect their family from dominant and insistent relatives who “intimidate” them. With this regard, the hospice expert has the vast opportunity as well as the responsibility to guard the patient along with the other relatives from this kind of bullying. These forms of concerns remain very realistic and are capable of occurring in whichever hospice (Long et al., 2014).

This literature provides considerable evidence, in which caregivers are concealed patients reliant on protection as of physical as well as emotional harm. According to the article interventions aimed at the family, the caregiver is supposed to serve two purposes. First, interventions are capable of bearing the caregiver as a consumer; openly lessening caregiver suffering as well as the force on their health along with their well-being. In this intervention, the caregiver remains the receiver of the express advantage as well as the patient gains merely secondarily. The other second objective is that interventions are capable of being aimed to help make the caregiver more competent and confident, providing safe and efficient care to the patient. This is clearly shown on the research results (Long et al., 2014).

This article provides the recommendations to perk up the care of patients in the ICU in the process of dying. The guidelines highlight current developments. They fail to employ an evident grading system for the reason that most guidelines are founded on legal and moral principles, which are not resultant from empirically-based evidence. According to the principal findings, Family-centered care remains an all-inclusive perfect for the management of EOL care in the ICU.  Healthcare providers in the ICU are supposed to be competent in the entire parts of care (Curtis & Vincent, 2010).

Many issues add to patients’ choice regarding which site to get hospice care. However, as healthcare providers, we desire to perk up patient-centered results by contrasting patient satisfaction along with the value of care flanked by inpatient hospice with home care hospice. Therefore, the major outcomes in the literature are families as well as patients’ individual rating of the value of hospice care, the way they reflect the services convene their personality needs as well as patients’ pain along with comfort management. Ideally, knowing more regarding the type of hospice care gives superior patient satisfaction as well as brings the nearly all advantage to patients remain imperative for caregivers to offer best patient-centered care. However, as the persons with the most communication with patients as well as know patients’ mental and physical states, nurses can modify the most proper care plan to congregate the person needs of diverse hospice patients. This is by having a well-built knowledge-base of distinctive and benefits of every type of hospice care. Ideally, nurses are supposed to consider that hospice care is regarding caring, other than not curing (Rothen, Stricker & Heyland, 2010).

Summary

In critically ill patients nearly dying, how is the healthcare providers and relatives’ company compared to non-presence result to positive outcomes and increased patient satisfaction at the time of palliative care. Nurses should be capable of performing improved physical and psychological assessments as well as create efficient patient-centered strategies with the deliberation of medical and mental needs of patients at the end stage.

References

Curtis, J. R., & Vincent, J. L. (2010). Ethics and end-of-life care for adults in the intensive care unit. The Lancet, 376(9749), 1347-1353.

Long, A. C., Kross, E. K., Engelberg, R. A., Downey, L., Nielsen, E. L., Back, A. L., & Curtis, J. R. (2014). Quality of dying in the ICU: is it worse for patients admitted from the hospital ward compared to those admitted from the emergency department? Intensive care medicine, 40(11), 1688-1697.

Rothen, H. U., Stricker, K. H., & Heyland, D. K. (2010). Family satisfaction with critical care: measurements and messages. Current opinion in critical care, 16(6), 623-631.