End-of-life care among terminally ill patients in the emergency department: a best practice implementation project.

Introduction: The increasing number of older adults visiting emergency departments (EDs) near the end of life highlights the need for palliative and end-of-life care in this setting, despite the ED's focus on acute care. Aim: This study implemented evidence-based end-of-life care for terminally ill...

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Publicado en:JBI Evidence Implementation Vol. 24; no. 3; pp. 466 - 478
Autores principales: Yang, Piaoyu, Feng, Li, Zhou, Wanting, Zheng, Jili, Zhang, Yuxia
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Jul2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2026
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      pub: Lippincott Williams & Wilkins
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        atl: End-of-life care among terminally ill patients in the emergency department: a best practice implementation project.
      aug:
        au:
          Yang, Piaoyu
          Feng, Li
          Zhou, Wanting
          Zheng, Jili
          Zhang, Yuxia
        affil: Department of Emergency, Zhongshan Hospital of Fudan University, Shanghai, China
      sug:
        subj:
          Terminal Care Standards
          Emergency Service
          Terminally Ill Patients
          Implementation Science
          Medical Practice, Evidence-Based
          Program Evaluation
          Funding Source
          China
          Human
          Hospitals
          Nursing Staff, Hospital
          Physicians
          Caregivers
          Family
          Questionnaires
          Scales
          Interviews
          Palliative Care
          Hospice Care
          Attitude of Health Personnel
          Patient Satisfaction
          Quality Improvement
          T-Tests
          Data Analysis Software
          Descriptive Statistics
      ab: Introduction: The increasing number of older adults visiting emergency departments (EDs) near the end of life highlights the need for palliative and end-of-life care in this setting, despite the ED's focus on acute care. Aim: This study implemented evidence-based end-of-life care for terminally ill adult patients in the ED in a medical center in Shanghai, China. Methods: This project followed JBI Evidence Implementation Framework. A baseline audit was conducted to measure current practices against best practice recommendations. Barriers to evidence-based practices were identified, improvement strategies were implemented, and a follow-up audit was conducted to determine changes in compliance. Results: The results showed significant improvement in adherence to best practice recommendations. For Criterion 1 (staff training), compliance rose from 77.5% to 100% and knowledge scores increased from 9.68 ± 1.945 to 12.30 ± 2.239 (p  < 0.001). For Criterion 2 (patients screened and/or assessed for palliative care needs), compliance increased from 50% to 100%. For Criterion 3 (ED protocol for end-of-life care), compliance rose from 0% to 100%. For Criterion 4 (palliative or end-of-life patients transitioned to the appropriate service), compliance increased from 0% to 30%. For Criterion 5 (strategies promoting a suitable environment), compliance increased from 70% to 90%. Conclusions: This project resulted in positive changes, including the establishment of a formal end-of-life care protocol. Nursing team support and the range of end-of-life care interventions also improved. However, collaboration and referrals between hospitals and hospices remain challenging. Further audits are needed to assess improvements in care for end-of-life patients. http://links.lww.com/IJEBH/A395
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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