74 Dying matters in the emergency department; understanding the staff experience of delivering end-of-life in a major trauma centre

<h3>Background</h3> End of life care (EOLC) is a national priority from the National Health Service in the United Kingdom (UK). One guarantee in life is that we all die. There is limited data or evidence around what EOLC involves in the ED and staff experience of delivering this care. We are a major trauma centre in the UK seeing around 250000 people annually. This work was looking to understand the staff experience of delivering EOL in an ED. <h3>Methods</h3> A department wide, open cross-sectional survey, using a self-administered questionnaire with closed and open-ended responses, was distributed electronically to all ED staff who are involved in ED EOLC. This included heath care assistants through to emergency medicine (EM) consultants. Participants were recruited anonymously. Ethics was not required, but permission was granted by the local clinical governance team. <h3>Results</h3> 101 (20%) clinical staff completed the survey. 40(40%) were nurses, 30 (30%) were doctors, 8 (8%) were ACPs, 17 (17%) were unregistered staff and there were 6 (6%) staff who described themselves as other. 30% had worked in EM for 3–5 years, with 32 (32%) having looked after someone who was EOL in the last week. Just over half 56 (56%) felt that the last patient they looked after who was dying, they could not give the care they would have liked. Challenges around delivering EOLC in the ED included time, space, poor patient flow, lack of training and noise. For those who were making EOL and DNACPR Decisions 53 (53%), 15 (15%) are doing this every shift and 28 (28%) are doing this weekly. <h3>Conclusion</h3> ED is a challenging environment to deliver EOL care, our local centre has highlighted some of the burden of this care and the challenges. More work is needed to understand these challenges in a deeper context.