Background/Aims Many ICU patients continue to die despite advances in medicine. It is important to provide patients with dignifed deaths. This includes symptoms assessment and management, spiritual, religious and psychological support for both patients and their families. The aim of the audit is to assess our current performance in proving end-of-life care in our ICU.
Methods A retrospective audit of patients who died between 1st July 2021 and 31st December 2021 at the ICU of Croydon University Hospital. Their electronic medical records were reviewed for assessment and management of end-of-life symptoms, provision of psychological and spiritual needs, patient and family involvement in end-of-life discussions and palliative care involvement.
Results 66 patients were studied. 37 of them were males and 29 females. 22 of the patients had a Covid positive status. The mean age of the patients was 60 years old. 77% of the patients were intubated. Of the intubated patients, 39% of patients had assessment for pain, 37% for agitation, 16% for secretions, 10% for nausea and vomiting and 12% for breathlessness. In contrast, 90% of the intubated patients had pharmacological management for pain, 88% for agitation, 92% respectively for secretions, nausea and vomiting as well as breathlessness. For the non-intubated patients, 85% of patients had pain and agitation assessments, 69% for secretions and breathlessness and 54% for nausea and vomiting. Spiritual support was offered in less than half (47%) of the patients. The local palliative care team were involved in a total of 12 cases.
Conclusions The most significant finding was the lack of documentation in our assessment of end-of-life symptoms in intubated patients. Many of the intubated patients had pharmacological management of their symptoms despite the lack of assessment as they were on sedatives. A dedicated end-of-life symptoms assessment section on the electronic system would be useful.
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