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A national survey exploring views and experience of health professionals about transferring patients from critical care home to die

A national survey exploring views and experience of health professionals about transferring patients from critical care home to die
A national survey exploring views and experience of health professionals about transferring patients from critical care home to die


Background: Transferring critically ill patients home to die is poorly explored in the literature to date. This practice is rare, and there is a need to understand health care professionals’ (HCP) experience and views.

Objectives: To examine (1) HCPs’ experience of transferring patients home to die from critical care, (2) HCPs’ views about transfer and (3) characteristics of patients, HCPs would hypothetically consider transferring home to die.

Design: A national study developing a web-based survey, which was sent to the lead doctors and nurses in critical care units.

Setting/participants: Lead doctors and senior nurses (756 individuals) working in 409 critical care units across the United Kingdom were invited to participate in the survey.

Results: In total, 180 (23.8%) completed surveys were received. A total of 65 (36.1%) respondents had been actively involved in transferring patients home to die and 28 (15.5%) had been involved in discussions that did not lead to transfer. Respondents were supportive of the idea of transfer home to die (88.8%). Patients identified by respondents as unsuitable for transfer included unstable patients (61.8%), intubated and ventilated patients (68.5%) and patients receiving inotropes (65.7%). There were statistically significant differences in views between those with and without experience and between doctors and nurses. Nurses and those with experience tended to have more positive views.

Conclusion: While transferring patients home to die is supported in critical care, its frequency in practice remains low. Patient stability and level of intervention are important factors in decision-making in this area. Views held about this practice are influenced by previous experience and the professional role held.
preferred place of death, choice, transfer, intensive care
0269-2163
363-370
Darlington, Anne-Sophie E.
472fcfc9-160b-4344-8113-8dd8760ff962
Long-Sutehall, Tracy
92a6d1ba-9ec9-43f2-891e-5bfdb5026532
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Coombs, Maureen A.
e7424ed2-6beb-481d-8489-83f3595fd04c
Darlington, Anne-Sophie E.
472fcfc9-160b-4344-8113-8dd8760ff962
Long-Sutehall, Tracy
92a6d1ba-9ec9-43f2-891e-5bfdb5026532
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Coombs, Maureen A.
e7424ed2-6beb-481d-8489-83f3595fd04c

Darlington, Anne-Sophie E., Long-Sutehall, Tracy, Richardson, Alison and Coombs, Maureen A. (2015) A national survey exploring views and experience of health professionals about transferring patients from critical care home to die. Palliative Medicine, 29 (4), 363-370. (doi:10.1177/0269216315570407). (PMID:25656087)

Record type: Article

Abstract



Background: Transferring critically ill patients home to die is poorly explored in the literature to date. This practice is rare, and there is a need to understand health care professionals’ (HCP) experience and views.

Objectives: To examine (1) HCPs’ experience of transferring patients home to die from critical care, (2) HCPs’ views about transfer and (3) characteristics of patients, HCPs would hypothetically consider transferring home to die.

Design: A national study developing a web-based survey, which was sent to the lead doctors and nurses in critical care units.

Setting/participants: Lead doctors and senior nurses (756 individuals) working in 409 critical care units across the United Kingdom were invited to participate in the survey.

Results: In total, 180 (23.8%) completed surveys were received. A total of 65 (36.1%) respondents had been actively involved in transferring patients home to die and 28 (15.5%) had been involved in discussions that did not lead to transfer. Respondents were supportive of the idea of transfer home to die (88.8%). Patients identified by respondents as unsuitable for transfer included unstable patients (61.8%), intubated and ventilated patients (68.5%) and patients receiving inotropes (65.7%). There were statistically significant differences in views between those with and without experience and between doctors and nurses. Nurses and those with experience tended to have more positive views.

Conclusion: While transferring patients home to die is supported in critical care, its frequency in practice remains low. Patient stability and level of intervention are important factors in decision-making in this area. Views held about this practice are influenced by previous experience and the professional role held.

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e-pub ahead of print date: 5 February 2015
Published date: April 2015
Keywords: preferred place of death, choice, transfer, intensive care
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 384410
URI: http://eprints.soton.ac.uk/id/eprint/384410
ISSN: 0269-2163
PURE UUID: e1aaef08-ea30-4530-94d9-9db3c286734f
ORCID for Tracy Long-Sutehall: ORCID iD orcid.org/0000-0002-6661-9215
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755

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Date deposited: 25 Nov 2015 15:41
Last modified: 05 Nov 2019 01:53

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Author: Maureen A. Coombs

University divisions

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