title: Implementation of a Life-Sustaining Management and Alternative Protocol for Actively Dying Patients in the Emergency Department.
abstract: OBJECTIVE
  The aging population and the growing number of home hospice patients have resulted in increased utilization of emergency departments. This situation poses a clinical challenge to the ED staff in determining when lifesaving treatment is indicated and when end of life care begins.
  
  
  METHODS
  Through a shared governance model, ED physicians and nursing staff aimed to implement a best practice model for the care of dying patients. An ED interdisciplinary team identified gaps and brainstormed methods to improve palliative measures and comprehensive care for actively dying patients.
  
  
  RESULTS
  A best practice initiative called "Life Sustaining Management and Alternatives" was developed and implemented to provide palliative care services and comprehensive care for patients who are actively dying in the emergency department.
  
  
  CONCLUSIONS
  The emergency department became better equipped to handle end of life care, providing adequate pain management, optimal comfort measures, and emotional support with respect and dignity for the dying patient and family. The practices implemented resulted in improved patient care, increased patient satisfaction, and reduced overall hospital admissions.
authors.affiliation: Paterson, NJ. Electronic address: rojase@sjhmc.org.
authors.forename: Eva
authors.initials: E
authors.lastname: Rojas
authors.affiliation: Paterson, NJ.
authors.forename: Richard
authors.initials: R
authors.lastname: Schultz
authors.affiliation: Paterson, NJ.
authors.forename: Heather Heil
authors.initials: HH
authors.lastname: Linsalata
authors.affiliation: Paterson, NJ.
authors.forename: Debra
authors.initials: D
authors.lastname: Sumberg
authors.affiliation: Paterson, NJ.
authors.forename: Maria
authors.initials: M
authors.lastname: Christensen
authors.affiliation: Paterson, NJ.
authors.forename: Cathlyn
authors.initials: C
authors.lastname: Robinson
authors.affiliation: Paterson, NJ.
authors.forename: Mark
authors.initials: M
authors.lastname: Rosenberg
mesh_terms: D001293:Attitude to Death; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011015:Pneumonia, Aspiration; D015397:Program Evaluation; D011782:Quadriplegia; D012131:Respiratory Insufficiency; D018805:Sepsis; D013727:Terminal Care / Q000379:methods*
keywords: Emergency department; End of life; Family; Geriatric; Hospice care; Palliative care