Privacy at end of life in ICU: a review of the literature

This article was published in Journal of Clinical Nursing February 2018 by Timmins et al.
Background:  While the provision of ICU care is vital, the nature and effect of the potential lack of privacy during death and dying in ICUs has not been extensively explored.
Aim:  This paper aims to explore the issues surrounding privacy during death in ICU.
Design:  A literature search using CINAHL and Pubmed revealed articles related to privacy, death and dying in ICU.
Method:  Key words used in the search were ‘ICU’, ‘Privacy’, ‘Death’ and ‘Dying’. A combination of these terms using Boolean operators ‘or’ or ‘and’ revealed a total of 23 citations. Six papers were ultimately deemed suitable for inclusion in the review and were subjected to code analysis with Atlas.ti v8 QDA software.
Findings:  The analysis of the studies revealed eight themes, and this paper presents the three key themes that were found to be recurring and strongly interconnected to the experience of privacy and death in ICU: ‘Privacy in ICU’, ‘ICU environment’ and ‘End-of-Life Care’.
Conclusions:  Research has shown that patient and family privacy during the ICU hospitalisation and the provision of the circumstances that lead to an environment of privacy during and after death remains a significant challenge for ICU nurses. Family members have little or no privacy in shared room and cramped waiting rooms, while they wish to be better informed and involved in end-of-life decisions. Hence, death and dying for many patients takes place in open and/or shared spaces which is problematic in terms of both the level of privacy and respect that death ought to afford.
Relevance to clinical practice:  It is best if end-of-life care in the ICU is planned and coordinated, where possible. Nurses need to become more self-reflective and aware in relation to end-of-life situations in ICU in order to develop privacy practices that are responsive to family and patient needs. This article is protected by copyright. All rights reserved.
Library members can order the full text of individual articles such as this one via the Rotherham NHS Foundation Trust Library and Knowledge Service using the article requests online via this link.

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