Anest. intenziv. Med. 2018;29(5):269-274

Application of palliative care in intensive care medicineIntensive Care Medicine - Original Paper

M. Metznerová¹, M. Zítková^2,*

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta, Masarykova univerzita, Fakultní nemocnice Brno

² Katedra ošetřovatelství, Lékařská fakulta Masarykovy univerzity

Objective:
Palliative care has become an integral part of intensive care medicine. The goal of the study was to map the actual process of change from active intensive care to palliative care in terminal patients unable to express their will in the ICU setting, and to describe the factors influencing this process in practice.

Design:
Monocentric, retrospective analysis of documents.


Setting:
Department of Anesthesiology and Intensive Care Medicine, University Hospital.

Materials and methods: The sample included medical records of 100 patients meeting the predefined study criteria. Written records of medical and nursing documentation describing the process of changing active intensive treatment into palliative care were examined. The data were processed by the STATISTICA 12 statistic software at significance level of 5 %.

Results:
The decision to change the management objective was made within 5 days of hospitalization in 60 % of patients. In 59 % of the cases, organ support was withheld. The change of the management objective was discussed with the next of kin in 93 % of the patients, in 58 % of patients it was discussed within 5 days of hospitalization.
A multidisciplinary team meeting was held less frequently. Nurses took part in 13 % of the case discussion.

Conclusion:
Patient care changes its objectives and processes. Our department has adopted palliative care into the management of critically ill patients which contributes to further improvement of the quality of patient care. More frequent involvement of multidisciplinary teams and nurses would be beneficial.

Keywords: intensive care medicine; palliative care; treatment escalation restriction; quality of life; quality of care

Received: June 5, 2018; Accepted: September 1, 2018; Published: October 1, 2018  Show citation