Improving end of life care: Symptom assessment and education for informal hospice caregivers (a quality improvement project)
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Nature and scope of the project: In the setting of COVID-19, more individuals experience the dying process in their home rather than at hospice facilities. Currently, there are limited resources to help informal caregivers identify signs and symptoms of death and dying. The Edmonton Symptom Assessment System (ESAS) is a standardized assessment tool that can be offered in the hospice setting. This quality improvement (QI) project aims to increase utilization of the ESAS tool among caregivers with loved ones enrolled in hospice.
Synthesis and analysis of supporting literature: Without adequate education on how to care for dying patients, patients may experience decreased quality of life, and caregivers may experience role strain, anxiety, and fatigue. Utilization of the ESAS tool improves patient-reported quality of life at the end of life and decreases caregiver burden.
Project implementation: Eligible participants received a pre-survey inquiring about current knowledge and comfort level of performing assessments. Education on the ESAS tool was delivered to participants with a pamphlet including 21 ESAS questionnaires. Three weeks following education, a post-survey was offered to participants to assess changes in knowledge.
Evaluation criteria: Pre- and post-survey data was compared. Qualitative and quantitative data was collected to analyze the ease of use, comfort level, and understanding of the ESAS tool by caregivers after education.
Outcomes/Recommendations: There was one participant who reported improvement in comfort level and knowledge of end of life symptoms but experienced no change in response to end of life symptoms. Results of this QI project were limited by the lack of participant involvement. Initial data suggests that caregivers find the ESAS tool user-friendly but is not beneficial for individuals with a prolonged hospice admission.
| Type | DNP Capstone Project |
| Acquisition | Self-submission |
| Review Type | None: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Quality Improvement |
| Research Approach | Mixed/Multi Method Research |
| Keywords | Hospice; End of Life; Caregiver; Edmonton Symptom Assessment Scale; Symptom Management; Quality of Life |
| Grantor | The College of St. Scholastica |
| Advisor | Larson, Mary |
| Level | DNP |
| Year | 2022 |
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