Giles Tracey M, Hammad Karen, Breaden Katrina, Drummond Christine, Bradley Sandra L, Gerace Adam, Muir-Cochrane Eimear
College of Nursing and Midwifery, Flinders University, Bedford Park, Adelaide, South Australia, Australia.
College of Nursing and Midwifery, Flinders University, Bedford Park, Adelaide, South Australia, Australia.
Int Emerg Nurs. 2019 Nov;47:100789. doi: 10.1016/j.ienj.2019.100789. Epub 2019 Sep 5.
The number of people dying in emergency departments (EDs) is increasing. However, EDs are not well designed or resourced for safe and effective End-Of-Life (EOL) care encounters, and there is little evidence regarding clinicians' perceptions and experiences of providing such care when the death is sudden and unexpected.
This study explored nurses' perceptions and experiences of caring for patients who die suddenly and unexpectedly in the ED.
Open-end responses were collected as part of a larger descriptive survey design. The qualitative data were analysed thematically.
211 ED nurse completed the online survey. Within the qualitative data, five themes were identified during analysis: 1) key elements of EOL care, 2) systemic and environmental barriers, 3) educational deficits, 4) role ambiguity, and 5) emotional impact. Participants identified communication, a standardised approach, and better educational preparedness as the most important elements of EOL care when the death was sudden and unexpected.
ED nurses want to provide high quality care to dying patients and their families. However, their efforts are hampered by systemic and environmental barriers outside their control. There is a need for a culture shift to overcome the barriers that currently obstruct ED nurses from providing meaningful and effective EOL care in the ED.
在急诊科死亡的人数正在增加。然而，急诊科在设计和资源配备上并不适合进行安全有效的临终关怀，而且几乎没有证据表明临床医生在面对突然且意外的死亡时，对提供此类护理的看法和经验。
本研究探讨护士对在急诊科突然且意外死亡患者的护理看法和经验。
作为一项更大规模描述性调查设计的一部分，收集开放式回答。对定性数据进行主题分析。
211名急诊科护士完成了在线调查。在定性数据中，分析过程中确定了五个主题：1）临终关怀的关键要素，2）系统和环境障碍，3）教育缺陷，4）角色模糊，5）情感影响。参与者认为，当死亡突然且意外时，沟通、标准化方法和更好的教育准备是临终关怀最重要的要素。
急诊科护士希望为临终患者及其家属提供高质量护理。然而，他们的努力受到其无法控制的系统和环境障碍的阻碍。需要进行文化转变，以克服目前阻碍急诊科护士在急诊科提供有意义且有效临终关怀的障碍。
