Emergency nurses' suggestions for improving end-of-life care obstacles

Area of Science:

• Emergency Medicine
• Palliative Care
• Nursing Research

Background:

• Emergency departments (EDs) handle over 123 million visits annually, with many patients dying during their stay.
• EDs are designed for life-saving interventions, not optimal end-of-life (EOL) care.
• Emergency nurses provide care for dying patients and their families within this challenging environment.

Purpose of the Study:

• To identify emergency nurses' suggestions for enhancing end-of-life (EOL) care within emergency departments.
• To gather qualitative data on improving the dying experience for patients and families in ED settings.

Main Methods:

• A survey was distributed to 1000 emergency nurses, with 230 providing 295 suggestions for improving EOL care.
• Qualitative content analysis was employed to categorize and theme the nurses' responses.
• Responses were coded, compared with existing literature, and analyzed until data saturation was achieved.

Main Results:

• Five major themes emerged: increased nurse time for EOL care, allowing family presence during resuscitation, comfortable patient rooms, patient privacy, and family grief rooms.
• Four minor themes were also identified, contributing to a comprehensive understanding of EOL care needs.
• The findings highlight specific areas for improvement in the ED EOL care environment.

Conclusions:

• Emergency departments serve a large patient population, including those nearing the end of life.
• Emergency nurses are uniquely positioned to identify barriers and solutions for improving EOL care.
• Implementing nurses' recommendations is crucial for enhancing the quality of end-of-life care in emergency settings.