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Nursing home nurses are pivotal in recognising resident deterioration and initiating the decision-making process on resident transfer to emergency departments. However, their decisions have not been adequately explored in the Asian context which places a strong emphasis on family connection and has a longstanding history of considering end-of-life discussion as a taboo.

To explore the experiences of nursing home nurses surrounding resident transfer to emergency departments during acute deterioration.

A descriptive qualitative study was undertaken. Individual semi-structured interviews were held from October to December 2019 with a purposive sample of 14 nurses from one nursing home in Singapore. Thematic analysis was performed on the data.

Five themes were identified: (i) knowing the residents; (ii) challenges in honouring residents’ advance care planning; (iii) family …