SciELO - Scientific Electronic Library Online

 
vol.40 issue3Predictive validity of Bishop and Burnett Scores for vaginal delivery modified by parity author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Anales del Sistema Sanitario de Navarra

Print version ISSN 1137-6627

Abstract

GIRBAU, M.B.; MONEDERO, P.; CENTENO, C.  and  GRUPO ESPANOL DE CUIDADOS AL FINAL DE LA VIDA EN UCI. Good care for patients who die in intensive care units in Spain. A study based on international care quality indicators. Anales Sis San Navarra [online]. 2017, vol.40, n.3, pp.339-349. ISSN 1137-6627.  https://dx.doi.org/10.23938/assn.0026.

Background.

To assess the quality of clinical care given to patients who die in intensive care units (ICU) in Spain.

Methodos.

A retrospective observational cohort study of patients who died in the ICU based on a Spanish sample. Inclusion criteria were patients older than 18 years who died in ICU after a minimum stay of 24 hours. Consecutive admissions without exclusions were analyzed. Excellence criteria in intensive care were assessed by quality indicators and measures, related to end-of-life care, developed by the Robert Wood Johnson Foundation Critical Care Workgroup.

Results.

Two hundred and eighty-two patients from 15 Spanish ICU were included. A median of 13% was observed in the achievement of the indicators. Almost all clinical records assessed both the patients’ decision making capacity (96%) and their communication with families (98%), while a plan of care goals was achieved in only 50% of them. Only two ICU had open visiting policies. Distress assessment (48%) was better than that of pain assessment (28%). The absence of protocol for the withdrawal of life-sustaining treatments was observed in thirteen ICU. The indicators of emotional and spiritual support were achieved in less than 10%.

Conclusions.

The quality of end-of-life care in the participating ICU needs to be improved. The study identifies shortcomings and indicates existing resources in clinical practice from which a gradual improvement plan, adapted to the situation in each hospital, can be designed. The analysis, inexpensive in its implementation, offers an opportunity for improvement, a goal recommended by most professional societies of intensive care medicine.

Keywords : End-of-life care; Intensive care; Critical care; Palliative care; Quality improvement.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )