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  • Poster presentation
  • Open Access

Evaluation of a new limitations and withdrawal of care framework order form in the intensive care unit

  • 1,
  • 1 and
  • 1
Critical Care201014 (Suppl 1) :P601

  • Published:


  • Public Health
  • Intensive Care Unit
  • Emergency Medicine
  • Patient Experience
  • Acute Illness


The aim of this study was to demonstrate improvements in both staff and patient experiences with end-of-life care. The ICU is a setting where death is common; it has been suggested that 20% of patients in the US die on the ICU [1]. Given that the majority of ICU deaths involve the withholding or withdrawing of treatment [2], the importance of end-of-life care is clear. Despite this frequency, studies suggest that the current quality of end-of-life care is suboptimal on the ICU [3, 4]. As a result, we developed a new framework to address this issue.


We introduced our new framework over a 1-year period; we circulated questionnaires to the staff pre and post study to demonstrate any improvements in end-of-life care.


Our framework was found to be helpful by 97% of respondents and was associated with an improvement in communication and knowledge of end-of-life care. We discovered an increase in the number of staff who felt that patients, along with having their analgesia/sedation needs met, were now experiencing care that was more conducive to a good quality of dying. The number of staff who now felt confident in managing withdrawal of care trended towards a significant P value. See Figure 1 for details.


Quality of end-of-life care was improved with our new framework; however, further research is vital to ensure our patients receive the same kind of evidence-based medicine in their final hours as they did during their acute illness.

Authors’ Affiliations

Queens Hospital, Romford, UK


  1. Angus DC, et al.: Crit Care Med. 2004, 32: 638-643. 10.1097/01.CCM.0000114816.62331.08PubMedView ArticleGoogle Scholar
  2. Wood GG, et al.: Can J Anaesth. 1995, 42: 186-191. 10.1007/BF03010673PubMedView ArticleGoogle Scholar
  3. Desbiens NA, et al.: J Am Geriatr Soc. 2000, 48: S183-S186.PubMedView ArticleGoogle Scholar
  4. Treece PD, et al.: Crit Care Med. 2004, 32: 1141-1147. 10.1097/01.CCM.0000125509.34805.0CPubMedView ArticleGoogle Scholar


© BioMed Central Ltd. 2010