Wendy G Anderson1, Kathleen Puntillo2, Deborah Boyle3, Susan Barbour4, Kathleen Turner4, Jenica Cimino5, Eric Moore6, Janice Noort6, John MacMillan6, Diana Pearson6, Michelle Grywalski3, Solomon Liao3, Bruce Ferrell7, Jeannette Meyer7, Edith O'Neil-Page7, Julia Cain8, Heather Herman8, William Mitchell8, Steven Pantilat5. 1. Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA. Electronic address: Wendy.Anderson@ucsf.edu. 2. Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, California, USA. 3. University of California, Irvine Health, Orange, California, USA. 4. University of California, San Francisco Medical Center, San Francisco, California, USA. 5. Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA. 6. University of California, Davis Medical Center, Sacramento, California, USA. 7. University of California, Los Angeles Medical Center, Los Angeles, California, USA. 8. University of California, San Diego Medical Center, San Diego, California, USA.
Abstract
CONTEXT: Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses. OBJECTIVES: To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication. METHODS: A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via e-mail in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, U.S. RESULTS: The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%). CONCLUSION: ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.
CONTEXT: Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses. OBJECTIVES: To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication. METHODS: A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via e-mail in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, U.S. RESULTS: The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%). CONCLUSION: ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.
Authors: Nicholas G Wysham; May Hua; Catherine L Hough; Stephanie Gundel; Sharron L Docherty; Derek M Jones; Owen Reagan; Haley Goucher; Jessica Mcfarlin; Christopher E Cox Journal: Crit Care Med Date: 2017-04 Impact factor: 7.598
Authors: Madison B Smith; Tamara G R Macieira; Michael D Bumbach; Susan J Garbutt; Sandra W Citty; Anita Stephen; Margaret Ansell; Toni L Glover; Gail Keenan Journal: Am J Hosp Palliat Care Date: 2018-03-08 Impact factor: 2.500