Table 1 Elements of the multi-modal intervention

Medication

“Warning list” (decision support tool for evaluation of sedative effects)

To provide cut-off values for dose intervals and doses, which are expected to result in a continuous effect/defined depth of sedation for sedative drugs for a defined “standard patient”, based on the available evidence and expert consensus

Recommendations regarding drug doses for initiating intentional sedation in SPC

To provide recommendations for selection of drugs and doses when starting intentional sedation in SPC, based on the available evidence and expert consensus

Information and consent

Information sheets for patients and legal representatives

To provide legally sound information for the use of intentional sedation in SPC practice and to support the decision-making process

Checklist for physicians on information provision

To guide the conversation between physician and patient during information and the declaration of consent by the patients and/or legal representatives ensuring decisions are properly documented

Handout for informal caregivers of sedated patients

To provide additional support for informal caregivers before or during the application of intentional sedation in SPC

Documentation

Documentation templates for health professionals in SPC and informal caregivers in home care settings

To guide documentation for different types of sedative drug use according to pre-existing documentation systems in various settings in SPC

Moral challenge analysis

Ethical screening tool

To guide the use of the moral challenges analysis tool

Analyses of ethically challenging situations from the perspective of medical ethics

To support ethical reflection on the use of sedative drugs in different SPC settings, e.g., for ethical case discussions

Checklists for deliberation on each analyzed ethically challenging situation

To support appropriate deliberation when dealing with ethically challenging situation

Informational brochure for patients and informal caregivers

To prevent ethical challenges, reduce stress for informal caregivers and minimize misunderstandings

Supplementary material

Educational materials for healthcare professionals

To provide information on the terminology, the multi-modal intervention and its elements, as well as support for the use of the tools