IMPROVING END-OF-LIFE CARE IN THE MEDICAL INTENSIVE CARE SETTING OF A MIDWEST HOSPITAL THROUGH NURSING PRACTICE ANALYSIS AND EDUCATION

The acuity of patients within the intensive care setting compounded by comorbidities and illness complications can lead to death in a large percentage of ICU admits annually. Increased mortality rates translate into end-of-life care being a prominent part of the critical care scope. Using a mixed methods approach the project looks to examine barriers, supportive measures, interdisciplinary communication, procedures, and leadership styles that determine quality end-of-life care. A comprehensive literature review revealed a number of barriers reported by nurses including a lack of interdisciplinary communication, disagreements on care plans, and a lack of communication with patients and their families about the acuity of their illness. Physicians reported difficulty knowing how to appropriately communicate with patients and their significant others about the severity of their illness and bringing up conversation about end-of-life care. Understanding barriers within end-of-life care in the ICU such as these allows the gap in care to be filled and quality care to be improved. Using a comprehensive literature review, quantitative questionnaires for nurses, implementing an end-of-life educational in-service, and analyzing practice changes and knowledge advancement through those interventions, this research aims to improve quality end-of-life care for patients in the ICU.