Experiences of intensive care unit nurses in end-of-life care at Ho Teaching Hospital, Ghana: a qualitative study

加纳霍教学医院重症监护室护士在临终关怀方面的经验:一项定性研究

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Abstract

BACKGROUND: Healthcare workers have an ethical obligation to provide quality end-of-life (EOL) care. Yet, substantial gaps persist in EOL practices globally and in Ghana specifically. Intensive care unit (ICU) nurses are pivotal in EOL care but frequently experience distress and unpreparedness when caring for dying patients. Ho Teaching Hospital, a major regional referral center in Ghana, has begun initial efforts to improve EOL care. However, systematic integration of EOL care principles is still lacking. AIM: This study aims to explore the experiences of ICU nurses providing EOL care at the Ho Teaching Hospital in Ghana, to understand the specific needs and challenges faced by this facility, and to drive targeted improvements. METHODS: The study employed an exploratory qualitative design and a purposive sampling method to recruit 20 nurses working in the ICU of the Ho Teaching Hospital in Ghana. The study used semi-structured interviews to gather data from the nurses who had experience providing EOL care to patients. Data was analysed thematically using NVivo version 14. RESULTS: Key findings from the interviews with ICU nurses revealed some major challenges which included inadequate equipment, understaffing, excessive workloads, and managing family-related issues. Nurses described the work as extremely stressful and emotionally draining. They frequently encounter traditional practices by families that interfere with medical care. The nurses recommended improving resources and equipment, enhancing training and support for staff, implementing communication and education programs, and increasing staffing. CONCLUSION: This study highlights the importance of improving intensive care nursing practices, including staffing, equipment availability, specialized training, and mental health support. These improvements can enhance care quality and nurse retention while also reducing burnout and emotional distress. Empowering frontline nurses and implementing evidence-based interventions can further improve care quality. The study recommends that policymakers should consider integrating EOL care modules into ICU nurses' continuing professional development, establishing mandatory staff counselling programs, and prioritizing resource allocation to critical care units.

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