The Effect of Proactive Clinical Ethics Consultations on End-of-life Care of the Critically Ill in the Intensive Care Settings
- Conditions
- Proactive Clinical Ethics Consultationthe Critically Ill
- Interventions
- Other: proactive clinical ethics consultation
- Registration Number
- NCT04926610
- Brief Summary
Study objective: This study is planning to explore factors predicting the use of life-sustaining treatment, develop the screening criteria of proactive clinical ethics consultations, the effect of proactive clinical ethics consultations and interprofessional practice on end-of-life care of the critically ill in the intensive care settings, and develop the competency for trainees by interprofessional education.
Methods: Data will be collected prospectively. Data between January 2013 and April 2014 was collected from hospital electronic record and ethics consultation document. All data will be analyzed for patients dying in the intensive care settings during the first stage of the study. Factors predicting the use of life-sustaining treatment will be determined. The Delphi technique will be applied to secure a consensus among the panel of experts chosen to help develop the screening criteria of proactive ethics consultations. A prospective randomized controlled trial will be conducted during the second stage of the study on a convenience sample of adult critical ill patients in the intensive care settings. Patients will randomize to the intervention group receive proactive ethics consultations. The control group will undergo routine intensive care, receiving clinical ethics consultations as requested by healthcare team, patients or family. All participants will be asked to complete a questionnaire rating their satisfaction with the healthcare process and consultations if conducted. Mean length of stay and the duration of the use of life-sustaining treatment will be compared between two groups. Secondary outcomes will include the proportion of satisfied families and healthcare team members. The interprofessional education with the core curriculum and case scenario for simulation will be developed, implement, and evaluated.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 224
- Medical staff involved in caring for terminal patients
- Cases of active clinical ethics consultation in our hospital
- Medical staff who refuse to participate in the study or are unable to understand the way the study is conducted
- Cases of refusing to participate in the research or unable to understand the way the research is conducted.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description proactive clinical ethics consultation group proactive clinical ethics consultation -
- Primary Outcome Measures
Name Time Method hospital length of stay through study completion, an average of 2 years days that patient in the hospital
use of life-sustaining treatment through study completion, an average of 2 years days of the use of life-sustaining treatment
ICU length of stay through study completion, an average of 2 years days that patient in the intensive care unit
- Secondary Outcome Measures
Name Time Method healthcare provider satisfaction questionnaire within 2 weeks after patient discharge healthcare provider satisfaction for ethics consultation
family or surrogate satisfaction questionnaire within 4 weeks after patient discharge family or surrogate satisfaction for patient care
Trial Locations
- Locations (1)
Kaohsiung Medical University Chung-Ho hospital
🇨🇳Kaohsiung, Taiwan