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The aim of this study was to demonstrate improvements in both staff and patient experiences with end-of-life care. The ICU is a setting where death is common; it has been suggested that 20% of patients in the US die on the ICU . Given that the majority of ICU deaths involve the withholding or withdrawing of treatment , the importance of end-of-life care is clear. Despite this frequency, studies suggest that the current quality of end-of-life care is suboptimal on the ICU [3,4]. As a result, we developed a new framework to address this issue.
We introduced our new framework over a 1-year period; we circulated questionnaires to the staff pre and post study to demonstrate any improvements in end-of-life care.
Our framework was found to be helpful by 97% of respondents and was associated with an improvement in communication and knowledge of end-of-life care. We discovered an increase in the number of staff who felt that patients, along with having their analgesia/sedation needs met, were now experiencing care that was more conducive to a good quality of dying. The number of staff who now felt confident in managing withdrawal of care trended towards a significant P value. See Figure Figure11 for details.
Quality of end-of-life care was improved with our new framework; however, further research is vital to ensure our patients receive the same kind of evidence-based medicine in their final hours as they did during their acute illness.