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Care of the dying cancer patient in the emergency department: findings from a N ational survey of A ustralian emergency department clinicians

2014; Wiley; Volume: 44; Issue: 4 Linguagem: Inglês

10.1111/imj.12379

1445-5994

Claudia H. Marck, Jennifer Weil, Heather Lane, Tracey Weiland, Jennifer Philip, Mark Boughey, George A Jelinek,

Emergency and Acute Care Studies

Abstract Background Patients with cancer are presenting to emergency departments ( ED ) for end‐of‐life care with increasing frequency. Little is known about this experience for patients and ED clinicians in A ustralia. Aims To assess the barriers and enablers regarding end‐of‐life care for cancer patients as perceived by A ustralian ED clinicians. Methods There were 4501 A ustralian ED clinicians invited through their professional colleges to complete an online survey, using multiple‐choice and free‐text responses. Results A total of 681 ED clinicians responded, most (84.2%) felt comfortable providing care to the dying and found it to be rewarding (70.9%). Although 83.8% found caring for the dying a reasonable demand on their role as clinician, 83.8% also agreed that the ED is not the right place to die. Respondents demonstrated a wide range of views regarding caring for this patient group in ED through free‐text responses. In addition, 64.5% reported that futile treatment is frequently provided in the ED ; the main reasons reported were that limitations of care were not clearly documented, or discussed with the patient or their family. Almost all (94.6%) agreed that advance care plans assist in caring for dying patients in the ED . Conclusions Our findings provide important new insights into a growing area of care for ED . Barriers and enablers to optimal care of the dying patient in ED were identified, and especially the reported high occurrence of futile care, likely a result of these barriers, is detrimental to both optimal patient care and allocation of valuable healthcare resources.