Enhancing Palliative Care Communication in Trauma and Surgical ICU Settings: A Systematic Review

Area of Science:

• Trauma Surgery
• Palliative Care
• Critical Care Medicine

Background:

• Palliative care in trauma ICUs faces challenges like prognostic uncertainty and time constraints.
• Early goals-of-care discussions are recommended for high-risk trauma patients.
• Implementation of these strategies in practice is not well understood.

Purpose of the Study:

• To identify communication strategies used in trauma critical care.
• To evaluate the impact of these strategies on patient and family-centered care.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Embase, CINAHL, Web of Science) up to October 2024.
• Studies focused on adult trauma/surgical ICU patients, palliative care, communication strategies, or goals-of-care discussions.
• Qualitative synthesis using grounded theory analysis was applied to extracted data.

Main Results:

• Thirty-nine studies were included, revealing five key themes: communication frameworks, interdisciplinary approaches, barriers, provider education, and impact on satisfaction.
• Structured communication tools (family meetings, checklists, decision aids) improved shared decision-making.
• Shared responsibility between palliative care and trauma teams was highlighted.

Conclusions:

• Structured communication and early interdisciplinary involvement positively impact family satisfaction and patient-centered outcomes.
• Standardized palliative communication in trauma ICUs remains a significant challenge.
• Future research should prioritize targeted education and standardized protocols.