Barriers to intensive care unit nurses providing terminal care: An integrated literature review

Laura A. Espinosa, Anne Young, Teresa Walsh

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


Traditional goals of critical care center on curative interventions for patients with acute illness. However, death is a common occurrence in critical care, which means a shift from curative care to comfort care. For a number of reasons, the transition in care is often not a smooth one. An integrated literature review was completed on 22 studies related to provision of terminal care. These 13 quantitative studies along with 9 qualitative studies identified specific barriers to effective terminal care provision including (a) lack of involvement in the plan of care and comfort, (b) disagreement among physicians and other healthcare team members, (c) inadequacy of pain relief, (d) unrealistic expectations of families, (e) nurses' difficulty coping, (f) lack of experience and education, (g) staffing levels, and (h) environmental circumstances. Recommendations address strategies to improve terminal care and suggest future research needed.

Original languageEnglish (US)
Pages (from-to)83-93
Number of pages11
JournalCritical Care Nursing Quarterly
Issue number1
StatePublished - Jan 1 2008


  • Barriers to care
  • Critical care
  • End of life
  • Nursing

ASJC Scopus subject areas

  • Nursing(all)
  • Critical Care and Intensive Care Medicine


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