Academic Journal
End-of-life care among terminally ill patients in the emergency department: a best practice implementation project.
| Title: | End-of-life care among terminally ill patients in the emergency department: a best practice implementation project. |
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| Authors: | Yang P; Department of Emergency, Zhongshan Hospital of Fudan University, Shanghai, China.; JBI Zhongshan Hospital Centre for Evidence-Based Practice, Shanghai, China., Feng L; Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, China.; JBI Zhongshan Hospital Centre for Evidence-Based Practice, Shanghai, China., Zhou W; Department of Emergency, Zhongshan Hospital of Fudan University, Shanghai, China.; JBI Zhongshan Hospital Centre for Evidence-Based Practice, Shanghai, China., Zheng J; Department of Emergency, Zhongshan Hospital of Fudan University, Shanghai, China.; JBI Zhongshan Hospital Centre for Evidence-Based Practice, Shanghai, China., Zhang Y; Department of Nursing, Zhongshan Hospital of Fudan University, Shanghai, China.; JBI Zhongshan Hospital Centre for Evidence-Based Practice, Shanghai, China. |
| Source: | JBI evidence implementation [JBI Evid Implement] 2026 Jul 01; Vol. 24 (3), pp. 466-477. Date of Electronic Publication: 2026 Jul 01. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 101772772 Publication Model: Electronic Cited Medium: Internet ISSN: 2691-3321 (Electronic) Linking ISSN: 26913321 NLM ISO Abbreviation: JBI Evid Implement Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Wolters Kluwer, [2020]- |
| MeSH Terms: | Terminal Care*/standards , Terminal Care*/methods , Emergency Service, Hospital*/standards , Palliative Care*/standards , Guideline Adherence*/statistics & numerical data , Terminally Ill*, Humans ; Evidence-Based Practice ; China ; Practice Guidelines as Topic ; Aged |
| Abstract: | Introduction: The increasing number of older adults visiting emergency departments (EDs) near the end of life highlights the need for palliative and end-of-life care in this setting, despite the ED's focus on acute care. Aim: This study implemented evidence-based end-of-life care for terminally ill adult patients in the ED in a medical center in Shanghai, China. Methods: This project followed JBI Evidence Implementation Framework. A baseline audit was conducted to measure current practices against best practice recommendations. Barriers to evidence-based practices were identified, improvement strategies were implemented, and a follow-up audit was conducted to determine changes in compliance. Results: The results showed significant improvement in adherence to best practice recommendations. For Criterion 1 (staff training), compliance rose from 77.5% to 100% and knowledge scores increased from 9.68 ± 1.945 to 12.30 ± 2.239 ( p < 0.001). For Criterion 2 (patients screened and/or assessed for palliative care needs), compliance increased from 50% to 100%. For Criterion 3 (ED protocol for end-of-life care), compliance rose from 0% to 100%. For Criterion 4 (palliative or end-of-life patients transitioned to the appropriate service), compliance increased from 0% to 30%. For Criterion 5 (strategies promoting a suitable environment), compliance increased from 70% to 90%. Conclusions: This project resulted in positive changes, including the establishment of a formal end-of-life care protocol. Nursing team support and the range of end-of-life care interventions also improved. However, collaboration and referrals between hospitals and hospices remain challenging. Further audits are needed to assess improvements in care for end-of-life patients. Spanish Abstract: http://links.lww.com/IJEBH/A395. (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the University of Adelaide, JBI.) |
| Competing Interests: | The authors declare no conflicts of interest. |
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| Contributed Indexing: | Keywords: emergency service; end-of-life care; evidence-based practice; hospital; palliative care |
| Entry Date(s): | Date Created: 20251007 Date Completed: 20260716 Latest Revision: 20260729 |
| Update Code: | 20260730 |
| DOI: | 10.1097/XEB.0000000000000526 |
| PMID: | 41054382 |
| Database: | MEDLINE |
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