Dimens Crit Care Nurs. 2021;40(4):237-247. doi: 10.1097/DCC.0000000000000479.
Critical care nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Obstacles to EOL care in ICUs exist and have been previously published along with reports from CCNs. Further data exploring obstacles faced during ICU EOL care may increase awareness of common EOL obstacles. Research focusing on obstacles related to physician behaviors and nursing issues (and others) may provide improvement of care.
The aim of this study was to gather first-hand data from CCNs regarding obstacles related to EOL care.
A random, geographically dispersed sample of 2000 members of the American Association of Critical-Care Nurses was surveyed. Responses from an item asking CCNs to tell us of the obstacles they experience providing EOL care to dying patients were analyzed.
There were 104 participants who provided 146 responses to this item reflecting EOL obstacles. These obstacles were divided into 11 themes; 6 physician-related obstacles and 5 nursing- and other related obstacles. Major EOL ICU barrier themes were inadequate physician communication, physicians giving false hope, poor nurse staffing, and inadequate EOL care education for nurses.
Poor physician communication was the main obstacle noted by CCNs during ICU EOL care, followed by physicians giving false hope. Heavy patient workloads with inadequate staffing were also a major barrier in CCNs providing EOL care.
重症监护病房（CCN）的护士经常在重症监护病房（ICU）提供临终关怀。在 ICU 中提供临终关怀存在障碍，并且已经与 CCN 的报告一起发布。进一步探索 ICU 临终关怀所面临的障碍的数据可能会增加对常见临终障碍的认识。专注于与医生行为和护理问题（和其他问题）相关的障碍的研究可能会改善护理。
本研究的目的是从 CCN 那里收集有关临终关怀相关障碍的第一手资料。
对美国危重病护理协会的 2000 名成员进行了随机、地理分布的抽样调查。对要求 CCN 告诉我们他们在为临终患者提供临终关怀时所经历的障碍的一项内容的答复进行了分析。
有 104 名参与者对该项目提供了 146 条反映临终障碍的意见。这些障碍分为 11 个主题；6 个与医生相关的障碍和 5 个与护理和其他相关的障碍。主要的 ICU 临终障碍主题包括医生沟通不足、医生给予虚假希望、护士人员配备不足以及护士临终关怀教育不足。
在 ICU 临终关怀期间，医生沟通不畅是 CCN 注意到的主要障碍，其次是医生给予虚假希望。工作量大且人员配备不足也是 CCN 提供临终关怀的主要障碍。
