title: Communication and decision making for patients with end stage diseases in an acute care setting.
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.
authors.affiliation: Department of Palliative Care, Flinders University, and Repatriation General Hospital, Adelaide SA, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Grbich
authors.forename: Karen
authors.initials: K
authors.lastname: Parish
authors.forename: Karen
authors.initials: K
authors.lastname: Glaetzer
authors.forename: Meg
authors.initials: M
authors.lastname: Hegarty
authors.forename: Lynne
authors.initials: L
authors.lastname: Hammond
authors.forename: Annie
authors.initials: A
authors.lastname: McHugh
mesh_terms: D000208:Acute Disease; D000328:Adult; D032722:Advance Care Planning / Q000592:standards; D001291:Attitude of Health Personnel; D003142:Communication; D003657:Decision Making; D005260:Female; D006301:Health Services Needs and Demand; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D007400:Interprofessional Relations; D007676:Kidney Failure, Chronic / Q000523:psychology*; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D008875:Middle Aged; D009731:Nursing Audit; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology* / Q000592:standards; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012189:Retrospective Studies; D013021:South Australia