Doctors' and nurses' views and experience of transferring patients from critical care home to die: a qualitative exploratory study.
BACKGROUND
Dying patients would prefer to die at home, and therefore a goal of end-of-life care is to offer choice regarding where patients die. However, whether it is feasible to offer this option to patients within critical care units and whether teams are willing to consider this option has gained limited exploration internationally.


AIM
To examine current experiences of, practices in and views towards transferring patients in critical care settings home to die.


DESIGN
Exploratory two-stage qualitative study


SETTING/PARTICIPANTS
Six focus groups were held with doctors and nurses from four intensive care units across two large hospital sites in England, general practitioners and community nurses from one community service in the south of England and members of a Patient and Public Forum. A further 15 nurses and 6 consultants from critical care units across the United Kingdom participated in follow-on telephone interviews.


FINDINGS
The practice of transferring critically ill patients home to die is a rare event in the United Kingdom, despite the positive view of health care professionals. Challenges to service provision include patient care needs, uncertain time to death and the view that transfer to community services is a complex, highly time-dependent undertaking.


CONCLUSION
There are evidenced individual and policy drivers promoting high-quality care for all adults approaching the end of life encompassing preferred place of death. While there is evidence of this choice being honoured and delivered for some of the critical care population, it remains debatable whether this will become a conventional practice in end of life in this setting.
['Coombs|Maureen|M|', 'Long-Sutehall|Tracy|T|', 'Darlington|Anne-Sophie|AS|', 'Richardson|Alison|A|']
D000328:Adult D001291:Attitude of Health Personnel D003422:Critical Care D005260:Female D017144:Focus Groups D006699:Home Care Services D006801:Humans D008297:Male D008875:Middle Aged D010360:Patient Transfer D036301:Qualitative Research D013727:Terminal Care D006113:United Kingdom
Critical care end-of-life care doctors and nurses transfer home