Monday, November 11, 2013

Critical Care Nurses' Perceptions of Obstacles, Supports, and Knowledge Needed in Providing Quality End-of-Life Care

Crump, Saundra K. PhD(c), MSN, RN, CHPN; Schaffer, Marjorie A. PhD, RN; Schulte, Evie BSN, RN, LAc

In response to critical care nurses' perceptions of increasing stress and conflict in difficult end-of-life (EOL) situations, the researchers conducted a study to identify perceived obstacles, supports, and knowledge needed to provide quality EOL care. 

The conclusions were as follows:

(1) Families and patients need clear, direct, and consistent information to make EOL decisions;

(2) Physician-related issues affect nurses' ability to provide quality EOL care;

(3) Critical care nurses need more knowledge, skill, and a sense of cultural competency to provide quality care; and

(4) Having properly completed advance directives can reduce confusion about the goals of care.

Recommendations for improving EOL care were made as a result of the study.

The study concluded that………..
  • Nurses must strengthen their role as liaisons between the patient and other health professionals to promote quality EOL care.
  • They need to advocate for the integration of a palliative care approach, such as the IPACC model into critical care settings.
  • This model emphasizes comfort and decreasing suffering while improving the overall quality of life for the patient.
  • Integrating Palliative and Critical Care requires education and a new way of thinking for all involved.
  • Physicians, nurses, and organizational leaders need to collaborate with patients and families to improve EOL care.
  • Nurses should lead the paradigm shift that supports IPACC.

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