Background The Intensive Care National Audit and Research Centre UK (ICNARC) revealed that approximately 20% of patients admitted to the Intensive Care Unit (ICU) will die there. End of life care decisions are a fundamental aspect of care on ICU, particularly given that 70% of the deaths that occur are following the withholding or withdrawal of life-sustaining treatments. Palliative care is increasingly accepted as an essential component of comprehensive care for critically ill patients. Most deaths are managed independently on the ICU, as such, patients preferred place of death (PPD) is not often explored or fully established.
To highlight the importance of end-of-life care and early palliative care team input to everyday practice and training for anaesthetists and intensivists.
To actively consider whether transfer home may be a component of end-of-life care for some patients.
Methods Our patient population are those inpatients receiving additional respiratory support on the ICU, non-invasive or invasive ventilation, who’s expressed their PPD as home. We recognise that collaborative and innovative working between teams within the acute and community sector is key to facilitating a safe and efficient transfer home for end-of-life care for patients requiring ventilatory support.
Results At our hospital, we have facilitated two patient transfers from ICU to home for withdrawal of ventilatory support and end-of-life care. Following these transfers, a comprehensive discharge checklist has been implemented, with key focus to ensuring a safe but time efficient transfer.
Conclusions To conclude, we are not asserting that transfer home at end-of-life is desirable or feasible for all critically unwell patients. However, we want to highlight the important of exploring patient wishes at this crucial stage of patient care.
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