Does not result in improved length of stay before death, time to withdrawal of mechanical ventilation
MONDAY, Sept. 13 (HealthDay News) -- An intervention program designed to improve end-of-life care in intensive care units (ICUs) fails to improve the quality of dying, length of ICU stay before death, or time from admission to withdrawal of life-sustaining measures, according to research published online Sept. 10 in the American Journal of Respiratory and Critical Care Medicine.
J. Randall Curtis, M.D., of the University of Washington in Seattle, and colleagues analyzed the effectiveness of a quality-improvement intervention program to which 12 hospitals were randomized (2,318 patients), collecting data from May 2004 to February 2008. The intervention targeted clinician education, academic detailing, local champions, feedback from clinicians on quality data, and system supports.
Following intervention, the researchers found no changes in family-completed Quality of Dying and Death (QODD) questionnaire results, in family satisfaction, or in nurse-completed QODD. There was an increase in ICU days prior to dying, but it was not a significant change; there was no change in time from ICU admission to withdrawal of mechanical ventilation.
"We found this intervention was associated with no improvement in quality of dying and no change in ICU length of stay prior to death or time from ICU admission to withdrawal of life-sustaining measures. Improving ICU end-of-life care will require interventions with more direct contact with patients and family," the authors write.
Abstract
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