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Nurses’ lived experiences of caring in palliative care - A phenomenological study
This study aimed to describe the lived experiences of nurses caring in a palliative care unit.
Development and evaluation of a policy recommendation for improving the palliative care experience: A quality improvement project
Nature and Scope of the Project:
Background: Palliative Care (PC) is the practice of alleviating and preventing symptoms of chronic or life-threatening illness across the lifespan (WHO, 2018). Unlike hospice care, PC can be considered along with curative treatment to focus on symptom management and goals of care to improve the patient's quality of life. An estimated 40 million people worldwide are in need of PC services, with only 14% currently receiving it (WHO, 2018).
Objective: To develop a policy recommendation that increases knowledge of PC practices as well as encourages the use of a screening tool to increase necessary referrals through utilization of required education and training amongst hospital staff and the use of the Palliative Care and Rapid Emergency Screening (P-CaRES) tool.
Synthesis and Analysis of Supporting Literature: Based on current literature, three emerging themes were identified to overcome obstacles relating to PC in a hospital setting: 1) provider training/education, 2) implementation of a tool to identify at-risk patients, and 3) incorporation of sustainability practices. According to Cerulus et al. (2021), standardized methods for PC training and identifying at-risk patients helps to reduce barriers in advanced care planning in a hospital setting, further supporting the need for policy change to incorporate these methods into practice.
Project Implemenation: A literature review was done to review current evidence-based practices found to overcome barriers to PC in the hosptial setting. A policy brief was created to be reviewed by expert evaluators. IRB approval was obtained.
Evaluation Criteria: A six question likert scale for evaluation of the policy brief was generated to be completed by seventeen expert evaluators. Four additional open-ended survey questions were added to the evaluation to assess common themes.
Outcomes: After evaluation of expert feedback (including responses from RNs, MDs, PAs, NPs, and Administration Managers) common themes were found. Overall, training implementation and tool incorporation to identify PC needs was agreed among evaluators that it would improve patient care. When asked "how confident are you that patients will benefit from these palliative care recommendations?", 100% of respondents were completely confident. However, concerns of time constraints in the ED and having "required" education would result in pushback from staff and prevent high-quality care discussions from taking place. There was also ocncern that creating specific PC consults could overwhelm a PC team.
Recommendations: After reviewing the evaluator responses on the policy brief, a few changes were made in an effort to improve the process....
Goals of care conversations: Palliative care practice change
Advance Directive (AD) documentation in the Electronic Healthcare Record (EHR) remains critical for palliative care (PC) patients to avoid unwanted treatments. Closer management of PC patients may close the AD completion ...
ELNEC final hours: Adapted for COVID-19 crisis
(End-of-Life Nursing Education Consortium (ELNEC), 2020)
The coronavirus pandemic has made care of patients and their families during the final hours of life uniquely challenging. Families are often not able to be with their loved ones during the end of their lives. Nurses are ...
Reliably assessing dyspnea in non-communicative end-of-life patients
Problem: Will education provided to nurses at a Midwest community hospital about the Respiratory Distress Observation Scale (RDOS) result in increased knowledge on how to assess patients who are unable to self-report ...
ELNEC COVID-19 meditation/mindfulness information
(End-of-Life Nursing Education Consortium (ELNEC), 2020)
Nurses are facing a great deal of stress caring for patients during the coronavirus pandemic. Meditation and mindfulness practices can help alleviate stress. This infographic outlines a number of helpful apps that can ...
ELNEC COVID-19 communication resource guide: Helping families saying goodbye virtually to loved ones in the nursing home and hospital
(End-of-Life Nursing Education Consortium (ELNEC), 2020-08-13)
Helping family members say goodbye to loved ones who are dying in the hospital or nursing home is difficult in the best circumstances. With COVID-19, visitation is often not allowed and family have to say goodbye using ...
Integrating palliative oncology care into doctor of nursing practice programs
(2018-06-25)
Objective: To integrate oncology palliative care content into DNP program curricula.
Creating joy & resilience in times of uncertainty
(End-of-Life Nursing Education Consortium (ELNEC), 2020)
Caring for older adults in long-term care facilities during the coronavirus pandemic is extremely challenging. Staff in long-term care are facing fears associated with the pandemic spread, grief associated with patient ...
ELNEC COVID-19 communication resource guide: Supporting a new graduate nurse colleague
(End-of-Life Nursing Education Consortium (ELNEC), 2020)
Transition from student to clinical practice as a new registered nurse can be overwhelming. The coronavirus pandemic has compounded the usual stressors and puts new graduates at high risk for stress, compassion fatigue and ...