The quality of intensive care unit nurse end of life handover :

Background: Quality ICU end-of-life-care has been found to be related to good communication. Handover is one form of communication that can be problematic due to lost or omitted information. A first step in improving care is to measure and describe it. Objective: The objective of this study was to describe the quality of ICU nurse handover related to end-of-life care and to compare the practices of different ICUs in three different countries. Design: This was a descriptive comparative study Settings: The study was conducted in seven ICUs in three countries; Australia (1 unit), Israel (3 units) and the UK (3 units). Participants: A convenience sample of 157 handovers was studied. Methods: Handover quality was rated based on the ICU End-of-Life Handover tool, developed by the authors. Results: The highest levels of handover quality were in the areas of goals of care and pain management while lowest levels were for legal issues (proxy and advanced directives) related to end of life. Significant differences were found between countries and units in the total handover score (country: F(2,154)=25.97, p=<.001; unit: F(6,150)=58.24, p=<.001) , for the end of life subscale (country: F(2, 154) = 28.23, p<.001; unit: F(6,150)=25.25, p=<.001), the family communication subscale (country: F(2,154)=15.04, p=<.001; unit: F(6,150)=27.38, p=<.001), the family needs subscale (F(2,154)=22.33, p=<.001; unit: F(6,150)=42.45, p=<.001) but only for units on the process subscale (F(6,150)=8.98, p=<.001. The total handover score