Nurses' estimations of patients' prognoses in the last days of life

This study was based on two medical wards in a teaching hospital. It examined the accuracy with which nurses estimated patients' prognoses in the last days and hours of life and the cues used to make such assessments. An exploratory and descriptive approach was adopted. The study was divided into two parts: a cross-sectional interview study and a prospective patient follow-up study. The cues used by the nurses were identified and categorised and estimates of life expectancy were assessed for accuracy. Results showed that multiple cues were used and that although nurses were able to identify patients who were dying imminently, their accuracy regarding precise prognosis varied considerably. They also revealed that the most accurate assessments were made by nurses carrying out basic patient care, rather than the most experienced staff.