Critical Appraisal of End-of-Life Care in Acute Hospital Setting

Running head: CRITICAL APPRAISAL
CRITICAL APRAISAL
Name of the Student:
Name of the University:
Author Note:

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Title:
Odgers, J., Fitzpatrick, D., Penney, W., &Shee, A. W. (2018). No one said he was dying:
Families' experiences of end-of-life care in an acute setting. The Australian Journal of
Advanced Nursing, 35(3), 21-31.
Abstract:
In this paper the authors have talked about the experiences and emotions of the family
members during end of life care of one of the dying family members. The authors have
substantially tried to examine the involved reactions and emotional outburst connected with the
patient during the last few days at a rural hospital setting (Odgers et al., 2018,p.22).
Introduction:
End of life care has been defined as the most challenging clinical care provided to
patients who are at their terminal age (Carey et al., 2013,p.178). As stated by Gilian et al. (2013),
end of life care typically involves the providence of palliative care and support in relation to the
special terminal needs of the patient in the last phase of life. It not only concerns delivering
substantial support to the dying patient but also takes care of the associated needs of the family
members. End of life care is extremely important for patients who are on the verge of their death.
However, in this paper the authors state that typically the acute hospital care settings are
primarily concerned with the diagnosis, treatment and discharge of the patients and fail to
identify that the patients might be in need of palliative care assistance (Herber & Johnston,
2013,p.228). According to Hudson et al. (2015), it has been stated that the process of identifying
the critical conditions of the patient and arranging proper end of life care or at the same time
arranging for palliative support is an extensively lengthy process. This often leads to the
deterioration of the condition of the patient and at the same time also leads to a degrading

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emotional status of the family members of the patient. This creates a negative experience for the
dying patient and at the same time the family members of the patient have to retain and live with
the reminiscence of the permanent absence of their loved ones (Keall et al., 2014,p.3198). Hence,
it is extremely important that acute hospitals engage in proactively managing the end of life care.
At the same time also include palliative care and support so as to thoroughly consider the wishes
of the patients at the terminal care and at the same time through effective measures educate the
family of the patient to deal with the condition in an optimistic manner (Odgerset al., 2018,p.29).
Literature Review:
Research papers have revealed that the death rate in the remote areas of Australia are
70% higher than in areas that are well connected to the network and roadways and at the same
time have better access to health care facilities (Lynch, 2013,p.1095;Odgerset et al., 2018,p.25).
It has been typically observed that there is a major lack of proper palliative care or standards to
elevate the quality of end of life care in the hospitals that are located at the remote Australian
region. Studies have also revealed that in more than 90% of the critical cases of patients who are
admitted to the hospital setting, the consent or the wishes of the patients are not taken into
consideration (Lynch et al., 2013,p.1096;Odgerset et al., 2018,p.29). It has also been recorded
that until and unless the physical health condition of the patients are extremely critical, clinical
decisions are made by the clinicians and the immediate family members of the patients for the
further treatment procedure (Rainsford et al., 2016,p.747). It should be crucially noted that no
research studies have been conducted so far in order to evaluate the reactions or the associated
emotions of the patients who are placed at the hospital and are experiencing end of life care
(Rosenwax et al., 2016,p.47).

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In most of the cases, it has been seen that the patients that who are at the end of life care
set up often die on account of the lack of proper support and care of life administered to enhance
the quality of the end of care life (Ray et al., 2014,p.272). Hence, it can be said that this paper
has successfully identified the literature gap present with accessing the quality of end of life care
administered to patient with critical illness at the terminal age. It has effectively contributed to
bridge the literature gap with the use of effective qualitative interviews that presents an insight to
the wishes and the perspectives of the patients and their immediate family members with end of
life care assistance activities in hospital settings.
Methodology:
The study has been conducted on the basis of an interpretive research study design. The
important elements of this research study can be enlisted as effective listening and observation in
correlation with the involved social, emotional and cultural co-factors (Teno et al., 2013,p.475).
The researchers have proceeded with the use of qualitative interviews with the immediate family
members of the critically or the terminally ill patients and tried to access the emotional rigmarole
that the family members go through on seeing their loves ones in pain (Thomas et al.,
2014,p.143). In this context, it can be said that the research study design that has been used by
the authors in this research study has made use of the interpretive research study which is a
refined version of the open-ended qualitative design and effectively makes use of the subject
responses during the interview and effectively generates credible and more authentic resources
which are not necessarily based upon the traditional qualitative research study design.
Another positive aspect that can be linked to the interpretive study design followed by the
authors of the research study can be enlisted as the critical consideration of the subject responses
in detail. This is important and must not be overlooked as it has been mentioned earlier that this