The end-of-life care practices of emergency care nurses and the factors that influence these practices: An integrative review

Introduction: Due to philosophical tensions between end-of-life care and emergency care, nurses in the emergency department face challenges in the provision of end-of-life care. The purpose of this integrative review was to synthesise evidence of the end-of-life care practices of emergency care nurses and the factors that influence these practices.Methods: For this integrative review, CINAHL, Embase, and MEDLINE databases were systematically searched in April 2020. In total, 30 studies written in English and published between 2010 and 2020 investigating the experiences of nurses caring for a patient that died in the emergency department were included. A constant comparative method was used to analyse and synthesise data.Results: End-of-life care practices prominent in the literature included modifying the environment for privacy, the provision of information to families and the management of symptoms. The culture of emergency care, the nurse's personal characteristics, the trajectory of death and available resources are factors that appear to determine whether ED nurses immerse themselves in end-of-life care or display distancing behaviours.Conclusion: There is limited evidence articulating the frequency to which specific practices are undertaken and the magnitude to which various factors influence end-oflife care provision. The generation of such knowledge may facilitate the development of initiatives that can optimise end-of-life care in the emergency department.