Managerial and organisational prerequisites for the implementation of palliative care in an intensive care setting : a qualitative study

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HAMDAN ALSHEHRI, Hanan | WOLF, Axel | OHLEN, Joakim | OLAUSSON, Sepideh

AIM: To explore the association of organisational structures when integrating palliative care in intensive care units. BACKGROUND: Palliative care within intensive care settings has been widely recognised as an area requiring improvement when caring for patients and their families. Despite this, intensive care units continue to struggle to integrate palliative care. METHODS: A qualitative descriptive methodology was used. Data was collected through research interviews with 15 managers and 36 healthcare professionals working in intensive care. The data was analysed adopting constant comparative analysis. RESULTS: This study provides insight into a diverse range of perspectives on organisational structure in the context of facilitation and the challenges posed. Three themes were identified: Do not resuscitate policy as a gateway to palliative care; facilitating family members to enable participation and support; barriers for palliative care in intensive care unit as a result of intensive care organisation. CONCLUSIONS: In fostering a sustainable organisational culture and practice development in intensive care, the findings indicate the need for specific palliative care policies and implementation strategies tailored according to context. IMPLICATIONS FOR NURSING MANAGEMENT: Management have a responsibility to facilitate dialogue within any multi-disciplinary team regarding palliative care and, in particular, to focus on 'do not resuscitate' policies as a gateway into this conversation.

https://onlinelibrary.wiley.com/doi/10.1111/jonm.13436

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