欧洲重症监护医学学会重症监护病房临终和姑息治疗指南要点学习2024年

1.引言

• 简述危重病患在ICU中的临终关怀和姑息治疗的重要性。

• 强调以患者为中心的护理，改善家属结果，以及支持ICU工作人员提供富有同情心和有效的临终关怀和姑息治疗。

2.研究方法

• 描述国际多学科专家小组的组成和研究方法。

• 说明研究问题的选择、文献搜索和证据评估过程。

3.国家间差异

• 分析不同国家在临终关怀实践上的差异。

• 讨论立法对临终关怀实践的影响。

4.决策制定

• 探讨在成人危重症患者中，获取、澄清和记录患者偏好和治疗目标的干预措施对结果的影响。

• 强调结构化决策制定策略的重要性。

5.姑息和临终关怀在ICU中的应用

• 评估早期整合姑息治疗对症状痛苦、生活质量和护理目标一致性的影响。

• 讨论使用标准化工具进行症状评估的频率。

6.沟通

• 分析ICU工作人员关于临终沟通的教育项目对结果的影响。

• 探讨通过印刷品、网站和视频等增强沟通工具对家属结果的影响。

7.家庭中心护理

• 讨论开放/灵活探视时间对家属结果的影响。

• 探讨是否允许家属在ICU中见证心肺复苏尝试对家属结果的影响。

8.跨专业决策制定

• 讨论跨专业决策共享对结果的影响。

9.冲突管理和职业倦怠

• 分析ICU专业人员在面对临终关怀时冲突管理策略的效果。

• 探讨预防性组织或个人策略在减轻ICU专业人员倦怠或心理痛苦方面的实施效果。

10.结论

• 总结提出的8项循证建议和19项专家意见。

• 强调数据的有限性并确定研究优先事项。

English Outline

1.Introduction

• Briefly describe the importance of end-of-life care and palliative care in the ICU for critically ill patients.

• Emphasize patient-centered care,improving outcomes for relatives,and supporting ICU staff in providing compassionate and effective end-of-life and palliative care.

2.Methods

• Describe the composition of the international multidisciplinary panel of experts and the methodology used.

• Explain the process of research question selection,literature search,and evidence assessment.

3.Variability Across Countries

• Analyze differences in end-of-life care practices across countries.

• Discuss the impact of legislation on end-of-life care practices.

4.Decision-Making

Explore the impact of interventions aimed at accessing,clarifying,and documenting patient preferences and goals of care in adult critically ill patients.

• Emphasize the importance of structured decision-making strategies.

5.Palliative and End-of-Life Care in the ICU

• Assess the impact of early integration of palliative care on symptom distress,quality of life,and alignment of care with patient goals.

• Discuss the frequency of symptom assessment using standardized tools.

6.Communication

• Analyze the impact of education programs on end-of-life communication for ICU staff.

• Explore the effects of enhanced communication tools such as brochures,websites,and videos on family outcomes.

7.Family-Centered Care

• Discuss the impact of open/flexible visiting hours on family outcomes.

• Explore the effects of allowing families to witness resuscitation attempts in the ICU on family outcomes.

8.Interprofessional Decision-Making

• Discuss the impact of interprofessional decision-sharing on outcomes.

9.Conflict Management and Burnout

• Analyze the effects of conflict management strategies among ICU professionals facing end-of-life situations.

• Discuss the implementation of preventive organizational or personal strategies in mitigating the prevalence of burnout or mental distress among ICU healthcare professionals.

10.Conclusion

• Summarize the 8 evidence-based recommendations and 19 expert opinions presented.

• Emphasize the limited availability of data and identify research priorities

Intensive Care Med

https://doi.org/10.1007/s00134-024-07579-1