Palliative Care and Intensive Care Units

Palliative care has become a crucial component of providing high-quality care to critically ill patients in the early 21st century. While efforts to assess the delivery of palliative care in critical-care settings have been made, few syntheses of published evaluation studies focusing on a wide-ranging selection of clinical and nonclinical outcomes exist. We thus systematically reviewed the evidence for effects of palliative care programs. Original research studies were selected, which evaluated the effect of palliative care interventions in medical, surgical, and combined intensive care units (ICUs) on selected clinical and nonclinical outcomes in ICUs. Search of MEDLINE/PubMed, CINAHL, and Web of Science from 2000 through 2013 was performed. The inclusion criteria included ICUs (surgical, medical, or combined) or ICU patients as the level of analysis and outcome evaluation of palliative care practices delivered in an ICU setting. The literature search revealed 1577 citations. Reviews of titles, abstracts, and articles resulted in 12 studies for inclusion. While quantitative evidence for the effects of palliative care interventions on patient and organizational outcomes was mixed, several consistent significant findings could be identified.