Elements of intensive care bereavement follow-up services: A European survey

Despite technological innovations and continuous improvement in evidence-based treatments, mortality in the intensive care unit (ICU) remains high. Consequently, a large group of family members may be in need of, and could benefit from, bereavement follow-up support.

To explore the elements, organization, and evaluation of ICU bereavement services in European countries. Specific objectives were to investigate: (a) the model of bereavement follow-up services (elements of support), (b) the workforce model (organization of staff), and (c) the evaluation model (evaluation strategies).

This was a cross-sectional survey of conference delegates.

A paper-and-pen questionnaire, including a cover letter assuring the respondents of anonymity and confidentiality, was distributed to 250 delegates during the opening ceremony of the 2017 European federation of Critical Care Nurses associations Congress in Belfast. The questionnaire was developed from a previously validated tool describing bereavement care practices in ICUs, including questions about the content and organization of bereavement follow-up services. Frequencies were calculated using yes/no questions, and content analysis was applied in additional free-text comments.

We received 85 responses from publicly employed nurses, mainly in mixed adult ICUs. Respondents were 48 (56.5%) bedside nurses, and the remaining respondents represented clinical nurse specialists, researchers, managers, or academic nurses. Bereavement follow up had existed for about 1 to 15 years. Important follow-up elements were: viewing the deceased in the unit, 77 (90.6%); providing follow-up information, 67 (79.8%); sending a letter of sympathy, 17 (20%); and calling the family to arrange a meeting, 27 (31%).

Bereavement follow up is common but variable in European ICUs. We recommend the development, implementation, and evaluation of evidence-based, but culture-specific, bereavement follow-up guidelines for European ICUs.

More critical care nurses are realizing the need for bereavement follow-up guidelines. This paper provides an overview of common elements that might be considered. WHAT IS KNOWN ABOUT THIS TOPIC Many families experience the death of a loved one in intensive care unit (ICU). Bereavement services are offered at some ICUs. WHAT THIS PAPER ADDS Bereavement services are not systematically offered in European ICUs. Culture-specific guidelines are needed for bereavement follow up in ICUs. Common elements of bereavement services have been identified, for example, viewing the deceased in the unit, providing follow-up information, sending a letter of sympathy, and calling the family to arrange a meeting. Consequences of bereavement in ICU have been discussed, for example, prolonged or complicated grief and lack of closure in the bereaved.