Transferring home to die from critical care units: A scoping review of international practices.

ABSTRACT

PURPOSE: To identify and characterise the international practices of transferring a dying patient home to die from critical care units. MATERIALS AND METHODS: A systematic scoping review following the Joanne Briggs Institute methodology was applied searching fifteen data sources to identify papers published in English and Chinese from 1970 to 2019. RESULTS: Of the 28 papers meeting eligibility criteria 19 were published in the West and seven in China. The number of patients being transferred home to die was larger in China (74/184-96/159) than in the West (1-7). Clinical characteristics of patients transferred included consciousness, with or without intubation and ventilation, and clinical stability. Reported key barriers to transfer included Lack of evidence guiding transfer practice, the CCU environment and culture, Practical and logistical factors and Family members expectations and reactions. Key facilitators of transfer were reported as Engagement with the multidisciplinary team and Personal patient and family wishes. CONCLUSIONS: Transferring patients home to die from critical care is a complex practice varying significantly across countries. Further research to address current knowledge gaps is important to inform policy and practice.