title: A national survey exploring views and experience of health professionals about transferring patients from critical care home to die.
abstract: BACKGROUND
  Transferring critically ill patients home to die is poorly explored in the literature to date. This practice is rare, and there is a need to understand health care professionals' (HCP) experience and views.
  
  
  OBJECTIVE
  To examine (1) HCPs' experience of transferring patients home to die from critical care, (2) HCPs' views about transfer and (3) characteristics of patients, HCPs would hypothetically consider transferring home to die.
  
  
  METHODS
  A national study developing a web-based survey, which was sent to the lead doctors and nurses in critical care units.
  
  
  METHODS
  Lead doctors and senior nurses (756 individuals) working in 409 critical care units across the United Kingdom were invited to participate in the survey.
  
  
  RESULTS
  In total, 180 (23.8%) completed surveys were received. A total of 65 (36.1%) respondents had been actively involved in transferring patients home to die and 28 (15.5%) had been involved in discussions that did not lead to transfer. Respondents were supportive of the idea of transfer home to die (88.8%). Patients identified by respondents as unsuitable for transfer included unstable patients (61.8%), intubated and ventilated patients (68.5%) and patients receiving inotropes (65.7%). There were statistically significant differences in views between those with and without experience and between doctors and nurses. Nurses and those with experience tended to have more positive views.
  
  
  CONCLUSIONS
  While transferring patients home to die is supported in critical care, its frequency in practice remains low. Patient stability and level of intervention are important factors in decision-making in this area. Views held about this practice are influenced by previous experience and the professional role held.
authors: Faculty of Health Sciences, University of Southampton, Southampton, UK a.darlington@soton.ac.uk.
authors: Anne-Sophie E
authors: AS
authors: Darlington
authors: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors: Tracy
authors: T
authors: Long-Sutehall
authors: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors: Alison
authors: A
authors: Richardson
authors: Faculty of Health Sciences, University of Southampton, Southampton, UK Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand.
authors: Maureen A
authors: MA
authors: Coombs
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness / Q000628:therapy; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D013727:Terminal Care / Q000458:organization & administration*; D006113:United Kingdom
keywords: Preferred place of death; choice; intensive care; transfer