Palliative Care Protocol for Adult Patients Hospitalized in Critical Care Units.

The goal of this clinical trial is to determine the effectiveness of a palliative care protocol in improving the quality of care of adult patients at high risk of dying hospitalized in the critical care unit. Assessing symptom burden (dyspnea, pain and/or anxiety/agitation) until death or day 5 (whichever comes first) Researchers will compare the impact of the palliative care protocol with standard care to see if it improves the quality of care. Participants will: 1. Symptom management. 2. Respect for the autonomy of the patient and his/her family environment. 3. Respectful management of clinical information. 4. Provision of holistic care and support.

We designed a stepped wedge cluster randomized trial The study is implementation in 5 Chilean hospitals, admitting 248 patients. Pre-intervention (control): The practices of each ICU will be maintained, until the moment that according to randomization corresponds the beginning of the intervention, in each center. Post-intervention: Palliative care protocol to improve the quality of care