End-of-life care in the intensive care unit: state of the art in 2006.

Evidence suggests that change is occurring in end-of-life care in the intensive care unit (ICU). There is a growing need and appreciation for the importance of education for the multidisciplinary team, but particularly for physicians, in gaining communication skills to improve the quality of end-of-life care and provide palliative care in the ICU. Studies have indicated that families are unhappy with the communication they receive when a family member is in the ICU. Evidence also suggests that families want to be involved in decisions about their loved one's care. Interventions have been tested in numerous ICUs that others can evaluate for application to their own facility in an attempt to create a global standard for end-of-life care in the ICU. Quality indicators have been defined, and an audit tool can help assess levels of performance.