Palliative care in the emergency department: A systematic literature qualitative review and thematic synthesis

Cooper, Esther; Hutchinson, Ann; Sheikh, Zain; Taylor, Paul; Townend, Will; Johnson, Miriam J.

Abstract

Background: Despite a fast-paced environment, the emergency clinician has a duty to meet the
palliative patient's needs. Despite suggested models and interventions, this remains challenging in
practice.
Aim: To increase understanding of these challenges by exploring the experience of palliative care
patients and their families and informal carers attending the emergency department, and of the
clinicians caring for them.
Design: Qualitative systematic literature review and thematic synthesis. Search terms related to
the population (palliative care patients, family carers, clinicians), exposure (the emergency
department) and outcome (experience). The search was international but restricted to English, and
used a qualitative filter. Title, abstracts and retrieved full texts were reviewed independently by two
reviewers against predefined inclusion criteria arbitrated by a third reviewer. Studies were appraised
for quality but not excluded on that basis.
Data Sources: MEDLINE [1946-], Embase[1947-], CINAHL [1981-] and PsycINFO [1987-] with a
bibliography search.
Results: 19 papers of 16 studies were included from Australia (n=5), the United Kingdom (n=5) and
United States (n = 9) representing 482 clinical staff involved in the emergency department (doctors,
nurses, paramedics, social workers, technicians), 61 patients and 36 carers. Nine descriptive themes
formed three analytic themes: “Environment and Purpose”; “Systems of Care and Interdisciplinary
Working” and “Education and Training”.
Conclusions: Provision of emergency palliative care is a necessary purpose of the emergency
department. Failure to recognise this, gain the necessary skills, or change the systems needed for an
environment better suited to its delivery perpetuates poor implementation of care in this
environment.

Citation

Cooper, E., Hutchinson, A., Sheikh, Z., Taylor, P., Townend, W., & Johnson, M. J. (2018). Palliative care in the emergency department: A systematic literature qualitative review and thematic synthesis. Palliative medicine, 32(9), 1443-1454. https://doi.org/10.1177/0269216318783920

• Journal Article Type: Article
• Acceptance Date: May 29, 2018
• Online Publication Date: Jul 20, 2018
• Publication Date: Oct 1, 2018
• Deposit Date: May 29, 2018
• Publicly Available Date: May 30, 2018
• Print ISSN: 0269-2163
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 9
• Pages: 1443-1454
• DOI: https://doi.org/10.1177/0269216318783920
• Keywords: Emergency department; Emergency care; Palliative; Experience; Qualitative
• Public URL: https://hull-repository.worktribe.com/output/854525
• Publisher URL: https://journals.sagepub.com/doi/10.1177/0269216318783920
• Contract Date: May 30, 2018