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However, no consensus exists on the most effective quality indicators (QIs) for assessing this care. This systematic review aims to identify and analyse the characteristics of QIs used in palliative and end-of-life care for ICU patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The Preferred reporting items for systematic review and meta-analysis 2020 guidelines will conduct this systematic review to ensure methodological transparency and rigour. A comprehensive literature search will be conducted across multiple databases, including PubMed, MEDLINE, EMBASE, Scopus, Google Scholar, ProQuest, EBSCOhost, ScienceDirect and BASE. Studies published up to 30 March 2025, will be included. The quality of indicators will be assessed using the appraisal of indicators through research and evaluation tool, and the characteristics of QIs will be analysed using the Donabedian model of quality. Data synthesis will include thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required as this study does not involve human participants. Findings will be disseminated through peer-reviewed publications and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42024513075.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101466","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T05:45:35Z","timestamp":1762753535000},"page":"e101466","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Palliative care and end-of-life quality indicators in critical patients in ICU: systematic review protocol"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9127-8312","authenticated-orcid":false,"given":"Heru","family":"Suwardianto","sequence":"first","affiliation":[{"name":"Doctoral Program of Nursing, Universitas Gadjah Mada, Faculty of Medicine Public Health and Nursing, Sleman, Special Region of Yogyakarta, Indonesia"},{"name":"Department of Critical Care and Emergency Nursing, Kediri Baptist Hospital College of Health Sciences, Kediri, East Java, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8823-229X","authenticated-orcid":false,"given":"Christantie","family":"Effendy","sequence":"additional","affiliation":[{"name":"Departement of Medical Surgical Nursing, Universitas Gadjah Mada, Faculty of Medicine Public Health and Nursing, Sleman, Special Region of Yogyakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri","family":"Setiyarini","sequence":"additional","affiliation":[{"name":"Department of Basic and Emergency Nursing, Universitas Gadjah Mada Faculty of Medicine Public Health and Nursing, Sleman, Special Region of Yogyakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,9]]},"reference":[{"key":"2025120413262517000_15.11.e101466.1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s44231-022-00009-0","article-title":"Palliative Care in the Intensive Care Unit: Not Just End-of-life Care","volume":"3","author":"Pan","year":"2023","journal-title":"Intensive Care Res"},{"key":"2025120413262517000_15.11.e101466.2","doi-asserted-by":"crossref","first-page":"e372","DOI":"10.1097\/CCM.0000000000002099","article-title":"Improving ICU-Based Palliative Care Delivery: A Multicenter, Multidisciplinary Survey of Critical Care Clinician Attitudes and Beliefs","volume":"45","author":"Wysham","year":"2017","journal-title":"Crit Care Med"},{"key":"2025120413262517000_15.11.e101466.3","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0B013E3181659096"},{"key":"2025120413262517000_15.11.e101466.4","article-title":"Comparison of ICU Mortality Rates Among Critically Ill COVID-19 Pneumonia Patients Across the First and Second Waves: A Single-Center Retrospective Analysis","volume":"17","author":"Vm","year":"2025","journal-title":"Cureus"},{"key":"2025120413262517000_15.11.e101466.5","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13195881","article-title":"Post-Intensive Care Syndrome as a Burden for Patients and Their Caregivers: A Narrative Review","volume":"13","author":"Schembari","year":"2024","journal-title":"J Clin Med"},{"key":"2025120413262517000_15.11.e101466.6","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006022"},{"key":"2025120413262517000_15.11.e101466.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-022-02855-5","article-title":"The mediation role of sleep quality in the relationship between cognitive decline and depression","volume":"22","author":"Liu","year":"2022","journal-title":"BMC Geriatr"},{"key":"2025120413262517000_15.11.e101466.8","doi-asserted-by":"crossref","unstructured":"Veneberg B , Tijsen LMJ , Wirtz MJ , et al . 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