Summary
End-of-life care in the ICU.
The role and responsibilities of ICU nurses
Marijke Noome
AIM: To get insight into the role and responsibilities of ICU nurses during endoflife care (EOLC).
METHOD: Three qualitative studies, two integrative reviews and one cluster RCT.
FINDINGS: Due to different paradigm shifts in care, like the shift towards patient and family-centred care, the exact role and responsibilities of ICU nurses have shifted as well. Consequently, an explicit role description is not available. Therefore, a Dutch guideline that includes 106 recommendations was developed. This guideline focuses on care for the patient, care for the family, and multidisciplinary care. For example, it is recommended that ICU nurses should take care of the ICU patient, as well as their family. In addition, ICU nurses could pay more attention to the spiritual aspects of care. And ICU nurses, as well as other involved professionals, should be involved in the decisionmaking process during EOLC.
CONCLUSION: ICU nurses and family of deceased ICU patients are satisfied with the overall care; however, some aspects need more attention to increase the quality of EOLC in the ICU. This can be achieved by improving care for the family, multidisciplinary care and spiritual care.
Keywords: End-of-life care, intensive care, nursing care, qualitative study, cluster RCT
