Oxford Brookes University, United Kingdom.
Oxford Brookes University, Oxford University Hospitals NHS Foundation Trust, Oxford Health, University of Technology Sydney, Australia, Health Education England Thames Valley, United Kingdom.
Int J Nurs Stud. 2018 Sep;85:106-117. doi: 10.1016/j.ijnurstu.2018.05.011. Epub 2018 May 23.
The aim of this integrative literature review was to explore the quality of the dying and death experience in the Emergency Department from the perspective of staff and carers.
Death in the Emergency Department is common. Understanding the quality of the death and dying experience of patients and their family members is crucial to building knowledge and improving care.
Systematic integrative literature review reported following the PRISMA guidelines.
Pubmed, Cumulative Index to Nursing and Allied Health Literature, Magonline (internurse), and the Cochrane library. Articles used were published in English during 1990- 2017.
Appraisal and thematic analysis.
Sixteen articles are included. Eight themes emerged from the literature: care in the Emergency Department is about living not dying, staff perceive that death is a failure, staff feel underprepared to care for the dying patient and family in this environment, there is limited time for safe standards of care, staff stress and distress, staff use of distancing behaviours, the care of the dying role is devolved from medics to nurses at the end of life, and patients and staff perceive that the Emergency Department is not the preferred place of death CONCLUSION: There are areas of concern about end of life care in the Emergency Department. To improve practice and to ensure that a good death occurs, further research is needed. There is a need to understand more about the experience of caregivers when a relative or friend dies in the Emergency Department.
本综述旨在从工作人员和护理人员的角度探讨急诊科临终和死亡体验的质量。
急诊科死亡较为常见。了解患者及其家属临终和死亡体验的质量对于构建知识和改善护理至关重要。
遵循 PRISMA 指南进行系统的综合文献回顾。
PubMed、Cumulative Index to Nursing and Allied Health Literature、Magonline(internurse)和 Cochrane 图书馆。使用的文章均发表于 1990 年至 2017 年期间的英文期刊。
评价和主题分析。
共纳入 16 篇文章。文献中有 8 个主题:急诊科的护理重点是生存而不是死亡,工作人员认为死亡是一种失败,工作人员感到在这种环境下对临终患者和家属的护理准备不足,没有足够的时间满足安全护理标准,工作人员压力和痛苦,工作人员使用隔离行为,临终关怀角色从医生转移到护士,患者和工作人员认为急诊科不是理想的死亡地点。
急诊科临终关怀存在一些令人担忧的地方。为了改进实践并确保实现善终,需要进一步研究。有必要更多地了解护理人员在亲人在急诊科死亡时的体验。