Original Article
Palliative and End-of-Life Care Education Needs of Nurses Across Inpatient Care Settings
Abstract
Background:
Educating nurses about palliative and end-of-life (EOL) care is a high priority in health care settings. The purpose of this study was to assess nurses' perceived competency regarding the provision of palliative and EOL care to hospitalized patients.
Method:
This study surveyed nurses from 25 pediatric and adult acute and intensive care units (ICU; N = 583) Quantitative data analysis was descriptive and correlational. Qualitative data analysis identified themes of participant concerns.
Results:
Data analysis revealed that perceived competency in palliative and EOL care is significantly higher in the ICU nurses (p <.0001). Mean scores were significantly higher when nurses had more than 10 years of experience (p <.0001). Open-ended responses indicated concerns regarding improved communication behaviors, decision making, and facilitation of continuity of care.
Conclusion:
The results provide guidance for development of palliative and EOL care nursing education programs tailored to address specific unit needs according to staff characteristics, patient population focus of care, and acuity level of care.
J Contin Educ Nurs. 2017;48(7):329–336.
- American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author. Google Scholar
- American Association of Critical-Care Nurses. (2016). Essentials of Critical Care Orientation (ECCO) 3.0. Retrieved from https://www.aacn.org/education/online-courses/essentials-of-critical-care-orientation Google Scholar
- Anderson W.G., Puntillo K., Boyle D., Barbour S., Turner K., Cimino J., Pantilat S. (2016). ICU bedside nurses' involvement in palliative care communication: A multicenter survey. Journal of Pain and Symptom Management, 51, 589–596.
10.1016/j.jpainsymman.2015.11.003 Crossref Medline, Google Scholar - Attia A.K., Abd-Elaziz W.W., Kandeel N.A. (2012). Critical care nurses' perception of barriers and supportive behaviors in end-of-life care. American Journal of Hospice & Palliative Medicine, 30, 297–304.
10.1177/1049909112450067 Crossref Medline, Google Scholar - Broglio K., Bookbinder M. (2014). Pilot of an online introduction to palliative care for nurses. Journal of Hospice and Palliative Nursing, 16, 420–429.
10.1097/NJH.0000000000000089 Crossref, Google Scholar - Centers for Disease Control and Prevention. (2016). Deaths: Final data for 2013. U.S. Department of Health and Human Services National Vital Statistics Report, 64(2), 1–119. Medline, Google Scholar
- Clarke E.B., Curtis J.B., Luce J.M., Levy M., Danis M., Nelson J., Solomon M.Z. (2003). Quality indicators for end-of-life care in the intensive care unit. Critical Care Medicine, 31, 2255–2262.
10.1097/01.CCM.0000084849.96385.85 Crossref Medline, Google Scholar - Espinosa L., Young A., Walsh T. (2008). Barriers to intensive care unit nurses providing terminal care: An integrated literature review. Critical Care Nursing Quarterly, 31(1), 83–93.
10.1097/01.CNQ.0000306402.55518.da Crossref Medline, Google Scholar - Gagnon J., Duggleby W. (2013). The provision of end-of-life care by medical-surgical nurses working in acute care: A literature review. Palliative and Supportive Care, 5(12), 393–408. Google Scholar
- Harris M., Gaudet J., O'Reardon C. (2014). Nursing care for patients at end of life in the adult intensive care unit. Journal of Nursing Education and Practice, 4(6), 84–89.
10.5430/jnep.v4n6p84 Crossref, Google Scholar - Institute of Medicine. (2014). Dying in America: Improving quality and honoring individual preferences near the end of life. Washington, DC: National Academies Press. Google Scholar
- Meier D., Beresford L. (2007). Pediatric palliative care offers opportunities for collaboration. Journal of Palliative Medicine, 10, 284–289.
10.1089/jpm.2006.9985 Crossref Medline, Google Scholar - Milic M., Puntillo K., Turner K., Joseph D., Peters N., Ryan R., Anderson W. (2015). Communicating with patients' families and physicians about prognosis and goals of care. American Journal of Critical Care, 24(4), e56–e64.
10.4037/ajcc2015855 Crossref Medline, Google Scholar - Moir C., Roberts R., Martz K., Perry J., Tivis L.J. (2015). Communicating with patients and their families about palliative and end-of-life care: Comfort and educational needs of nurses. International Journal of Palliative Nursing, 21, 109–112.
10.12968/ijpn.2015.21.3.109 Crossref Medline, Google Scholar - Montagnini M., Smith H., Balistrieri T. (2012). Assessment of self-perceived end-of-life care competencies of intensive care unit providers. Journal of Palliative Medicine, 15, 29–36.
10.1089/jpm.2011.0265 Crossref Medline, Google Scholar - Morrison R.S., Meier D.E. (2011). The national palliative care research center and the center to advance palliative care: A partnership to improve care for persons with serious illness and their families. Journal of Pediatric Hematology and Oncology, 33, 126–131.
10.1097/MPH.0b013e318230dfa0 Crossref, Google Scholar - Pelant D., McCaffrey T., Beckel J. (2012). Development and implementation of a pediatric palliative care program. Journal of Pediatric Nursing, 27, 394–401.
10.1016/j.pedn.2011.06.005 Crossref Medline, Google Scholar - Puntillo K. (2011). Integrating palliative care in the ICU: The nurse in a leading role. Journal of Hospice and Palliative Nursing, 13, 89–94.
10.1097/NJH.0b013e318203d9ff Crossref Medline, Google Scholar - Rajamani A., Barrett E., Weisbrodt L., Bourne J., Palejs P., Gresham R., Huang S. (2015). Protocolised approach to end-of-life care in the ICU—The ICU PALCare pilot project. Anaesthesia and Intensive Care, 43, 335–340. Crossref Medline, Google Scholar
- Sato K., Inoue Y., Umeda M., Ishigamori I., Igarashi A., Togashi S., Eguchi K. (2014). A Japanese region-wide survey of the knowledge, difficulties and self-reported palliative care practices among nurses. Japan Clinical Oncology, 44, 718–728.
10.1093/jjco/hyu075 Crossref, Google Scholar - Stayer D., Lockhart J. (2016). Living with dying in the pediatric intensive care unit: A nursing perspective. American Journal of Critical Care, 25, 350–356.
10.4037/ajcc2016251 Crossref Medline, Google Scholar - White K.R., Coyne P.J. (2011). Nurses' perceptions of educational gaps in delivering end-of-life care. Oncology Nursing Forum, 38, 711–717.
10.1188/11.ONF.711-717 Crossref Medline, Google Scholar - White K.R., Roczen M.L., Coyne P.J., Wiencek C. (2014). Acute and critical care nurses' perceptions of palliative care competencies: A pilot study. The Journal of Continuing Education in Nursing, 45, 265–277.
10.3928/00220124-20140528-01 Link, Google Scholar - World Health Organization. (2015). Palliative care fact sheet. Retrieved from http://www.who.int/mediacentre/factsheets/fs402/en/ Google Scholar
