Work

Documentation and evaluation of care of dying patients

Year: 2025

Type: article

Abstract: Evaluate the quality of documentation and delivery of EOLC in the Intensive Care Unit (ICU) during the COVID-19 pandemic and compare with a pre-pandemic audit. Retrospective clinical audit of medical records of patients who died in ICU during the COVID-19 pandemic, January 2021 to February 2022, using the Documentation and Evaluation of Care of Dying Equation (DECODE) survey tool. Three metropolitan adult ICUs in Victoria, Australia. DECODE audit score, patient characteristics, demographics, end of life planning, quality of death indicators, management of dying. There were 194 deaths over a 14-month period. 2 cases were excluded. Patients wishes were documented in 83 (43%) cases. A total of 175 patients (91%) were receiving active treatment 24 h before death. A total of 166 deaths (86%) were expected and occurred a mean of 4.5 (IQR 2-9) days from admission to ICU. A total of 52 (27%) had palliative or symptom control care plans. The median DECODE score was 14 (IQR 12-15) with statistical variation across the three sites ( p=0.001 ). Compared to pre pandemic audits, the DECODE score was higher ( p=0.001 ) despite pandemic restrictions. EOLC in ICU remains challenging due to diagnostic dilemmas, prognostic uncertainty, and short time-frames. Assessment of quality of EoLC care helps assess and possibly improve provision of care. The DECODE questionnaire provides a semi-objective measure of quality of care provided to the dying patient in ICU.

Source: Critical Care and Resuscitation

DOI: 10.1016/j.ccrj.2025.100136

Authors: Maria de Freitas, Lucinda Roberts, Alexandra Cockroft, Graeme Duke

Institution: Eastern Health

Language: English

Topic: Palliative Care and End-of-Life Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,300