TY - JOUR
T1 - Assessing palliative care practices in intensive care units and interpreting them using the lens of appropriate care concepts. An umbrella review
AU - Salins, Naveen
AU - Dhyani, Vijay Shree
AU - Mathew, Mebin
AU - Prasad, Ashmitha
AU - Rao, Arathi Prahallada
AU - Damani, Anuja
AU - Rao, Krithika
AU - Nair, Shreya
AU - Shanbhag, Vishal
AU - Rao, Shwethapriya
AU - Iyer, Shivakumar
AU - Gursahani, Roop
AU - Mani, Raj Kumar
AU - Bhatnagar, Sushma
AU - Simha, Srinagesh
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Purpose: Intensive care units (ICUs) have significant palliative care needs but lack a reliable care framework. This umbrella review addresses them by synthesising palliative care practices provided at end-of-life to critically ill patients and their families before, during, and after ICU admission. Methods: Seven databases were systematically searched for systematic reviews, and the umbrella review was conducted according to the guidelines laid out by the Joanna Briggs Institute (JBI). Results: Out of 3122 initial records identified, 40 systematic reviews were included in the synthesis. Six key themes were generated that reflect the palliative and end-of-life care practices in the ICUs and their outcomes. Effective communication and accurate prognostications enabled families to make informed decisions, cope with uncertainty, ease distress, and shorten ICU stays. Inter-team discussions and agreement on a plan are essential before discussing care goals. Recording care preferences prevents unnecessary end-of-life treatments. Exceptional end-of-life care should include symptom management, family support, hydration and nutrition optimisation, avoidance of unhelpful treatments, and bereavement support. Evaluating end-of-life care quality is critical and can be accomplished by seeking family feedback or conducting a survey. Conclusion: This umbrella review encapsulates current palliative care practices in ICUs, influencing patient and family outcomes and providing insights into developing an appropriate care framework for critically ill patients needing end-of-life care and their families.
AB - Purpose: Intensive care units (ICUs) have significant palliative care needs but lack a reliable care framework. This umbrella review addresses them by synthesising palliative care practices provided at end-of-life to critically ill patients and their families before, during, and after ICU admission. Methods: Seven databases were systematically searched for systematic reviews, and the umbrella review was conducted according to the guidelines laid out by the Joanna Briggs Institute (JBI). Results: Out of 3122 initial records identified, 40 systematic reviews were included in the synthesis. Six key themes were generated that reflect the palliative and end-of-life care practices in the ICUs and their outcomes. Effective communication and accurate prognostications enabled families to make informed decisions, cope with uncertainty, ease distress, and shorten ICU stays. Inter-team discussions and agreement on a plan are essential before discussing care goals. Recording care preferences prevents unnecessary end-of-life treatments. Exceptional end-of-life care should include symptom management, family support, hydration and nutrition optimisation, avoidance of unhelpful treatments, and bereavement support. Evaluating end-of-life care quality is critical and can be accomplished by seeking family feedback or conducting a survey. Conclusion: This umbrella review encapsulates current palliative care practices in ICUs, influencing patient and family outcomes and providing insights into developing an appropriate care framework for critically ill patients needing end-of-life care and their families.
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U2 - 10.1007/s00134-024-07565-7
DO - 10.1007/s00134-024-07565-7
M3 - Review article
AN - SCOPUS:85201231638
SN - 0342-4642
VL - 50
SP - 1438
EP - 1458
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 9
ER -