Palliative care in the intensive care unit: an interview-based study of the team perspective

Abstract

Background: The provision of palliative care is an evolving and expanding issue, with the inclusion and management of non-malignant conditions gaining increasing focus. This has seen provision of palliative care expand into increasingly acute settings, an example of which is the rising recognition of the need for good quality end-of-life-care in intensive care units (ICU). Methods: This qualitative interview-based study aimed to explore in depth the Stirling Royal Infirmary ICU team’s views and experiences of the difficulties of providing palliative care in an intensive care setting, and identification of the dying patient. Results: The ICU team reported there to be a number of advantages to providing end-of-life care in the ICU in terms of access to nursing and medical care. They also reported there to be issues surrounding training, identification of palliative care patients and over-aggressive management. Further collaboration between ICU and palliative medicine is required to develop understanding between the two specialties and expand provision of palliative care in this unique clinical setting.