Factors influencing integrated palliative care processes in intensive care units: a mixed methods systematic review

Background: Burn units are intensive care facilities specialized in the treatment of patients with severe burns. As burn injuries have a major impact in physical, psychosocial, and spiritual health, palliative care can be a strengthening component of integrated care. Aim: To review and appraise the existing evidence about the integration of palliative care in burn intensive care units with respect to (1) the concept, model and design and (2) the benefits and outcomes of this integration. Design: A systematic review was conducted following PRISMA guidelines. Protocol registered with PROSPERO (CRD42018111676). Data sources: Five electronic databases were searched (PubMed/NLM, Web of Science, MEDLINE/TR, Ovid, and CINAHL/EBSCO) until May 2019. A narrative synthesis of the findings was constructed. Hawker et al.’s tool was used for quality appraisal. Results: A total of 299 articles were identified, of which five were included for analysis involving a total of 7353 individuals. Findings suggest that there may be benefits from integrating palliative care in burn units, specifically in terms of patients’ comfort, decision-making processes, and family care. Multidisciplinary teams may experience lower levels of burden as result of integrating palliative care in burn units. Conclusion: This review reflects the challenging setting of burn intensive care units. Evidence from these articles suggests that the integration of palliative care in burn intensive care units improves patients’ comfort, decision-making process, and family care. Further research is needed to better understand how the integration of palliative care in burn intensive care units may be fostered and to identify the outcomes of this integration.

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Faculty Opinions recommendation of A systematic review comparing the relative effectiveness of antimicrobial-coated catheters in intensive care units.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1120380.576559 ◽

2008 ◽

Author(s):

Thomas Elliott ◽

Anna Casey

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Intensive Care Units ◽

Relative Effectiveness

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Faculty Opinions recommendation of Alpha-2 agonists for sedation of mechanically ventilated adults in intensive care units: a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726258625.793517295 ◽

2016 ◽

Author(s):

D John Doyle

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Intensive Care Units ◽

Mechanically Ventilated

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Faculty Opinions recommendation of Outbreaks of extended spectrum beta-lactamase-producing Enterobacteriaceae in neonatal intensive care units: a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727797241.793534162 ◽

2017 ◽

Author(s):

Jean-Ralph Zahar

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Neonatal Intensive Care Units ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

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Factors influencing the negotiation of ethnic identity among 1.5 and second-generation Asian migrants: A mixed methods systematic review

Journal of Adolescence ◽

10.1016/j.adolescence.2021.04.005 ◽

2021 ◽

Vol 89 ◽

pp. 95-112

Author(s):

Lovely Dizon ◽

Vanessa Selak ◽

Rodrigo Ramalho ◽

Roshini Peiris-John

Keyword(s):

Systematic Review ◽

Ethnic Identity ◽

Mixed Methods ◽

Second Generation ◽

Factors Influencing

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Barriers of Palliative Care in Neonatal Intensive Care Units

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909115616597 ◽

2016 ◽

Vol 34 (3) ◽

pp. 205-211 ◽

Cited By ~ 10

Author(s):

Mansooreh Azzizadeh Forouzi ◽

Marjan Banazadeh ◽

Jila Soltan Ahmadi ◽

Farideh Razban

Keyword(s):

Palliative Care ◽

Organizational Culture ◽

Intensive Care ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Attitude Scale ◽

Neonatal Intensive Care Units ◽

Cross Sectional ◽

Neonatal Nurses ◽

Eol Care

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.

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Oral care and nosocomial pneumonia: a systematic review

Einstein (São Paulo) ◽

10.1590/s1679-45082015rw2980 ◽

2015 ◽

Vol 13 (2) ◽

pp. 290-296 ◽

Cited By ~ 12

Author(s):

Maria Carolina Nunes Vilela ◽

Gustavo Zanna Ferreira ◽

Paulo Sérgio da Silva Santos ◽

Nathalie Pepe Medeiros de Rezende

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Intensive Care Units ◽

Nosocomial Pneumonia ◽

Oral Hygiene ◽

Oral Care ◽

Control Group ◽

Level Of Evidence ◽

Grade Of Recommendation ◽

Minimal Bias

To perform a systematic review of the literature on the control of oral biofilms and the incidence of nosocomial pneumonia, in addition to assessing and classifying studies as to the grade of recommendation and level of evidence. The review was based on PubMed, LILACS, and Scopus databases, from January 1st, 2000 until December 31st, 2012. Studies evaluating oral hygiene care related to nosocomial infections in patients hospitalized in intensive care units were selected according to the inclusion criteria. Full published articles available in English, Spanish, or Portuguese, which approached chemical or mechanical oral hygiene techniques in preventing pneumonia, interventions performed, and their results were included. After analysis, the articles were classified according to level of evidence and grade of recommendation according to the criteria of the Oxford Centre for Evidence-Based Medicine. A total of 297 abstracts were found, 14 of which were full articles that met our criteria. Most articles included a study group with chlorhexidine users and a control group with placebo users for oral hygiene in the prevention of pneumonia. All articles were classified as B in the level of evidence, and 12 articles were classified as 2B and two articles as 2C in grade of recommendation. It was observed that the control of oral biofilm reduces the incidence of nosocomial pneumonia, but the fact that most articles had an intermediate grade of recommendation makes clear the need to conduct randomized controlled trials with minimal bias to establish future guidelines for oral hygiene in intensive care units.

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