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Communication and Decision Making for Patients With End Stage Diseases in an Acute Care Setting
Carol F Grbich
School of Medicine, Flinders University, Adelaide SA
Karen Parish
Director of Nursing and Patient Services, Repatriation General Hospital, Adelaide SA
Karen Glaetzer
Nursing Coordinator, Outreach Palliative Care, Southern Adelaide Palliative Services, Repatriation General Hospital, Adelaide SA
Meg Hegarty
Department of Palliative Care, Flinders University, Adelaide SA
Lynne Hammond
Palliative Care Clinical Nurse, Southern Adelaide Palliative Services, Repatriation General Hospital, Adelaide SA
Annie McHugh
Palliative Care Clinical Nurse, Southern Adelaide Palliative Services, Repatriation General Hospital, Adelaide SA
Abstract
Twenty retrospective patient case studies were collated in an acute care teaching hospital using a case note audit and in addition interviews were undertaken with 40 nursing staff following the deaths of these patients in order to: analyse the end of life care received; identify any deficits in care provision and to enable the nursing division to target any inadequacies in care found.
Findings indicated that communication between medical and nursing staff and between nursing staff, patients and family around end of life issues continue to be poor and that discussions regarding NFR decisions occurred too close to death, creating unnecessary stress for both patients and families. Recommendations regarding palliative approaches in the acute care setting are detailed.
Keywords
palliative care, acute care setting, patient communication, patient decision making, nurses decision making
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