Intensive care nurse perceptions of family-centred end of life care and quality of dying

Many Australians will die expectedly within a hospital setting. The intensive care unit (ICU) is a particularly challenging environment to provide excellent end of life care. The aim of this study was to investigate intensive care nurse perceptions of the quality of dying and death of patients who died receiving end of life care and their perspectives as to whether this care met the needs of the patient’s families. An ethically-approved descriptive study was conducted, involving 35 nurses reporting via online survey on the most recent patient that they cared for in the ICU, and who subsequently died receiving end of life care. Overall, statistical analysis of quantitative survey items revealed that quality of dying and death was perceived by nurses as good, whereas satisfaction with meeting family needs ranged from fair to good. Following an inductive analysis of the open-ended survey items, six key categories of meeting family needs emerged: quality of care, emotional support, communicating and providing information, spending time with loved one, physical and environmental comfort, and spiritual care. The quantitative and qualitative results of the current study also identified several areas where nurses perceive quality of dying and death and meeting family needs intersect: symptom control, presence of family, dignity, and spiritual care. The development and testing of tools that measure the quality of end of life care in an Australian ICU setting is an important priority for future research.