The integrative review identified specific end-of-life care practices of emergency care nurses and the factors that influenced these practices.
•The domains of end-of-life care practice are: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management, and spiritual support.
•The end-of-life care practices of emergency care nurses are influenced by evidence, context, and factors of facilitation.
•By identifying the specific end-of-life care practices of emergency care nurses and the factors that influence them, targeted interventions may be developed to optimise end-of-life care in the emergency department.
AbstractIntroductionDue to philosophical tensions between end-of-life care and emergency care, nurses in the emergency department face challenges in the provision of end-of-life care. The purpose of this integrative review was to synthesise evidence of the end-of-life care practices of emergency care nurses and the factors that influence these practices.
MethodsFor this integrative review, CINAHL, Embase, and MEDLINE databases were systematically searched in April 2020. In total, 30 studies written in English and published between 2010 and 2020 investigating the experiences of nurses caring for a patient that died in the emergency department were included. A constant comparative method was used to analyse and synthesise data.
ResultsEnd-of-life care practices prominent in the literature included modifying the environment for privacy, the provision of information to families and the management of symptoms. The culture of emergency care, the nurse’s personal characteristics, the trajectory of death and available resources are factors that appear to determine whether ED nurses immerse themselves in end-of-life care or display distancing behaviours.
ConclusionThere is limited evidence articulating the frequency to which specific practices are undertaken and the magnitude to which various factors influence end-oflife care provision. The generation of such knowledge may facilitate the development of initiatives that can optimise end-of-life care in the emergency department.
KeywordsEmergency department
Emergency nursing
Nurses
End-of-life care
Terminal care
Palliative care
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