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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