Interprofessional interventions and factors that improve end-of-life care in intensive care units: An integratory review

Introduction: The changes in health dynamics, caused by the SARS-CoV-2 pandemic and its consequences, generated a greater need to integrate palliative care in the ICU to promote a dignified death. Objective: Identify interprofessional interventions and factors that improve the care of patients at the end of life. Methodology: Integrative review, including experimental, quasi-experimental, observational, analytical, and descriptive studies with correlation of variables, published from 2010 to 2021, identified in Cochrane, CINAHL, CUIDEN, LILACS, SciELO, Dialnet, PsychInfo, PubMed, ProQuest Psychology Journals and ScienceDirect, with the MeSH terms: "Critical Care'', "Intensive Care'', "Life support care'', "Palliative care'', "Life Quality'', "Right to die''. A total of 36,271 were identified; after excluding duplicates and because of title, abstract, year of publication, design, theme, methodological quality, objectives, and content, 31 studies were found. Results: It included 31 articles, 16.7% experimental, 3.3% quasi-experimental, 80% observational, analytical, and descriptive with correlation of variables, 38% published in the United States, and 19% in Brazil. The pooled sample was 24,779 participants. A percentage of 32.2 of the studies had level of evidence 1 recommendation (c), and 25.8% level of evidence 2 recommendation (c). This paper synthesizes evidence to promote interprofessional collaborative practice in the ICU, improve end-of-life care, and interventions to achieve established therapeutic goals, implement effective care policies, plans, and programs for critically ill patients and their families; factors that affect palliative care and improve with training and continuing education for health personnel. Conclusion: There are interventions to manage physical and emotional symptoms, training strategies and emotional support aimed at health personnel and family members to improve the quality of death and reduce stays in the ICU. The interdisciplinary team requires training on palliative and end-of-life care to improve care. (c) 2023 Sociedad Espanola de Enfermer<acute accent>& imath;a Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier Espana, S.L.U. All rights reserved.