Navigating communication with families during withdrawal of life‐sustaining treatment in intensive care: a qualitative descriptive study in Australia and New Zealand

Bloomer, Melissa; Endacott, Ruth; Ranse, Kristen; Coombs, Maureen

doi:10.1111/jocn.13585

Cited by 36 publications

(41 citation statements)

References 19 publications

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“…35,58 While no observational studies focused primarily on nurse communication, in interviews both physicians and nurses recognized the importance of nurses communicating with families on a more personal, individualized level. 33,35,49–51,54,55 Nurses often reported translating what doctors had said into less technical language. 49,54,55,58 Nurses highlighted their role in giving patients a clearer idea of what treatments would mean for the individual patient and bringing together information from different sources.…”

Section: Resultsmentioning

confidence: 99%

Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence

et al. 2019

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Background: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a ‘good death’. To improve communication, it is important to first identify how this is currently being accomplished. Aim: To review qualitative evidence concerning characteristics of communication about prognosis and end-of-life care between healthcare professionals and relatives of patients approaching the end-of-life. Design: Qualitative systematic review (PROSPERO registration CRD42017065560) using thematic synthesis. Peer-reviewed, English language articles exploring the content of conversations and how participants communicated were included. No date restrictions were applied. Quality of included studies was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data sources: An electronic database search of CINAHL, MEDLINE, PsycINFO and EMBASE was performed. Results: Thirty-one papers were included. Seven themes were identified: highlighting deterioration; involvement in decision-making, post-decision interactional work, tailoring, honesty and clarity, specific techniques for information delivery and roles of different healthcare professionals. Varied levels of family involvement in decision-making were reported. Healthcare professionals used strategies to aid understanding and collaborative decision-making, such as highlighting the patient’s deterioration, referring to patient wishes and tailoring information delivery. Doctors were regarded as responsible for discussing prognosis and decision-making, and nurses for providing individualized care. Conclusion: Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals.

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Section: Resultsmentioning

confidence: 99%

Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence

et al. 2019

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“…Nurses facilitate regular communication with the treating team (Brooks et al, 2017) and advocate for family needs and priorities (Ranse et al, 2016;Riegel et al, 2019). ICU nurses also spend time preparing families for imminent death (Bloomer et al, 2017), acknowledging family members' vulnerability (Mossin & Landmark, 2011) and providing immediate bereavement support (Raymond et al, 2017). Creating space and privacy for families to hold vigil (Brooks et al, 2017;Slatyer et al, 2015) and spend time with the dying person is also facilitated by ICU nurses.…”

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confidence: 99%

Editorial: COVID-19 and what it means for end-of-life care in ICU: Balancing the priorities

Bloomer

Bouchoucha

2020

Collegian

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“…This can impact their understanding and subsequent decision-making. Research studies have investigated some family-focused communication interventions in the ICU [ 4 , 9 ]; however, interventions were targeted at end-of-life care [ 4 , 10 ] and not generalisable across all types of family and HCP communication that occurs in the ICU.…”

Section: Study Synopsismentioning

confidence: 99%

Application of the READY framework supports effective communication between health care providers and family members in intensive care

Mackie

Mitchell

Schults

2021

Australian Critical Care

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Effective communication between intensive care health care providers and family is crucial to support surrogate or shared decision-making and to individualise care. Despite its importance in health care standards and policy, the quality of communication with families in intensive care is regarded as suboptimal. Furthermore, an intensive care admission is an extremely stressful event for families, which may impact their understanding and subsequent decision-making. Communicating with family members is a routine practice in intensive care; however, health care providers often receive no formal communication training. To date, family-focused communication interventions in intensive care have targeted end-of-life care and are not generalisable across all types of familyehealth care provider communication interactions. Mugweni et al. recently reported the results of a multiprofessional training intervention involving 26 health care professionals to improve the delivery of different news to families during pregnancy and at birth. A critique of this article has been undertaken to inform routine communication with critically ill family members and optimise the delivery of care in intensive care units.

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Navigating communication with families during withdrawal of life‐sustaining treatment in intensive care: a qualitative descriptive study in Australia and New Zealand

Abstract: How nurses navigate communication with families during treatment withdrawal is just as important as what is communicated. Nurses need access to supports and education opportunities in order to be able to perform this vital role.

Cited by 36 publications

References 19 publications

Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence

Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence

Editorial: COVID-19 and what it means for end-of-life care in ICU: Balancing the priorities

Application of the READY framework supports effective communication between health care providers and family members in intensive care

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