Emergency Nurses' Perceptions of Obstacle and Support Behavior Magnitudes in End-of-Life Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/162646
Type:
Presentation
Title:
Emergency Nurses' Perceptions of Obstacle and Support Behavior Magnitudes in End-of-Life Care
Abstract:
Emergency Nurses' Perceptions of Obstacle and Support Behavior Magnitudes in End-of-Life Care
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Beckstrand, Renea L., PhD, RN, CCRN
P.I. Institution Name:Brigham Young University
Title:Associate Professor
Contact Address:422 SWKT, P.O. Box 25432, Provo, UT, 84602, USA
Contact Telephone:(801) 422-3873
Co-Authors:Michelle D. Smith, RN, MS, NP-C; Sondra Heaston, MS, NP-C, CEN; A. Elaine Bond, DNSc, APRN, CCRN
[Research Poster] Purpose: Emergency nurses care for dying patients on a daily basis. The process of dying in an emergency department (ED) can be complicated. Research on specific obstacles that impede and supportive behaviors that help the delivery of end-of-life care in emergency departments is limited. The purpose of this study is to determine the size, frequency, and magnitude of: (a) obstacles to providing end-of-life care and (b) supportive behaviors in the care of dying patients, as perceived by Emergency Nurses.

Design: A descriptive study design was used.

Setting: A random sample of 700 geographically dispersed members of the Emergency Nurses Association (ENA). Subjects were in the United States and could read English.

Sample: Emergency nurses who had worked at some time in an emergency department, and who had cared for at least one dying ED patient. This study was IRB approved.

Methodology: A 70-item questionnaire was mailed to randomly selected ENA members. Two additional mailings were completed to non-responders to increase the response rate. Subjects were asked to rate obstacle items on size and frequency in caring for ED patients at the end-of life. Subjects were also asked to rate supportive behaviors on size and frequency in caring for ED patients at the end-of-life. There were 70 total items on the questionnaire with 51 of them having a Likert-type response option. There were five open-ended questions and 14 demographic questions. Cronbach's alpha for the 28 obstacle size items was .94 and for obstacle frequency it was .88. Cronbach's alpha for the 23 supportive behavior size items was .88 and for supportive behavior frequency it was .86. Frequencies, measures of central tendency and dispersion, and reliability statistics were calculated for all obstacle size and frequency items and for all supportive behavior size and frequency items. Items were then ranked on the basis of their mean scores to determine which items were perceived to be the largest obstacles or supportive behaviors and which items were perceived to occur most frequently. Each obstacle item?s size mean was then multiplied by the item's frequency mean to obtain either a perceived obstacle magnitude score or a perceived supportive behavior score.

Results: 384 questionnaires were returned with 112 of these eliminated because the respondents reported being ineligible (n = 95) or because the questionnaire came back undelivered (n = 17). Useable responses were received from 272 nurses for a response rate of 46.2%. Of the 269 respondents who reported their gender, 230 were women (85.5%) and 39 were men (14.5%). Nurses ranged in age from 26 to 72 years with a mean age of 47.3 years old. The items with the highest perceived obstacle magnitude were: (a) emergency nurses' work loads being too high to allow adequate time for patient care, (b) poor design of emergency departments, and (c) family members not understanding what "life-saving measures" really mean. The three highest scoring supportive behaviors were: (a) allowing family members adequate time to be alone with the patient after he or she has died; (b) having good communication between the physician and RN; and (c) providing a peaceful, dignified bedside scene for family members once the patient has died.

Conclusions: It is hoped that the results of this study will help increase and facilitate the discussions regarding end-of-life care in emergency departments. Realistic initial implications based on the magnitude scores of items include finding ways to decrease workloads of emergency nurses and increase direct patient care. Another important implication would be the improvement of emergency department designs which could improve end-of-life care in emergency departments. Further research in the area of end-of-life care in emergency settings is recommended.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEmergency Nurses' Perceptions of Obstacle and Support Behavior Magnitudes in End-of-Life Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162646-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Nurses' Perceptions of Obstacle and Support Behavior Magnitudes in End-of-Life Care</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Beckstrand, Renea L., PhD, RN, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Brigham Young University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">422 SWKT, P.O. Box 25432, Provo, UT, 84602, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(801) 422-3873</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">renea@byu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Michelle D. Smith, RN, MS, NP-C; Sondra Heaston, MS, NP-C, CEN; A. Elaine Bond, DNSc, APRN, CCRN</td></tr><tr><td colspan="2" class="item-abstract">[Research Poster] Purpose: Emergency nurses care for dying patients on a daily basis. The process of dying in an emergency department (ED) can be complicated. Research on specific obstacles that impede and supportive behaviors that help the delivery of end-of-life care in emergency departments is limited. The purpose of this study is to determine the size, frequency, and magnitude of: (a) obstacles to providing end-of-life care and (b) supportive behaviors in the care of dying patients, as perceived by Emergency Nurses.<br/><br/>Design: A descriptive study design was used. <br/><br/>Setting: A random sample of 700 geographically dispersed members of the Emergency Nurses Association (ENA). Subjects were in the United States and could read English.<br/><br/>Sample: Emergency nurses who had worked at some time in an emergency department, and who had cared for at least one dying ED patient. This study was IRB approved. <br/><br/>Methodology: A 70-item questionnaire was mailed to randomly selected ENA members. Two additional mailings were completed to non-responders to increase the response rate. Subjects were asked to rate obstacle items on size and frequency in caring for ED patients at the end-of life. Subjects were also asked to rate supportive behaviors on size and frequency in caring for ED patients at the end-of-life. There were 70 total items on the questionnaire with 51 of them having a Likert-type response option. There were five open-ended questions and 14 demographic questions. Cronbach's alpha for the 28 obstacle size items was .94 and for obstacle frequency it was .88. Cronbach's alpha for the 23 supportive behavior size items was .88 and for supportive behavior frequency it was .86. Frequencies, measures of central tendency and dispersion, and reliability statistics were calculated for all obstacle size and frequency items and for all supportive behavior size and frequency items. Items were then ranked on the basis of their mean scores to determine which items were perceived to be the largest obstacles or supportive behaviors and which items were perceived to occur most frequently. Each obstacle item?s size mean was then multiplied by the item's frequency mean to obtain either a perceived obstacle magnitude score or a perceived supportive behavior score. <br/><br/>Results: 384 questionnaires were returned with 112 of these eliminated because the respondents reported being ineligible (n = 95) or because the questionnaire came back undelivered (n = 17). Useable responses were received from 272 nurses for a response rate of 46.2%. Of the 269 respondents who reported their gender, 230 were women (85.5%) and 39 were men (14.5%). Nurses ranged in age from 26 to 72 years with a mean age of 47.3 years old. The items with the highest perceived obstacle magnitude were: (a) emergency nurses' work loads being too high to allow adequate time for patient care, (b) poor design of emergency departments, and (c) family members not understanding what &quot;life-saving measures&quot; really mean. The three highest scoring supportive behaviors were: (a) allowing family members adequate time to be alone with the patient after he or she has died; (b) having good communication between the physician and RN; and (c) providing a peaceful, dignified bedside scene for family members once the patient has died. <br/><br/>Conclusions: It is hoped that the results of this study will help increase and facilitate the discussions regarding end-of-life care in emergency departments. Realistic initial implications based on the magnitude scores of items include finding ways to decrease workloads of emergency nurses and increase direct patient care. Another important implication would be the improvement of emergency department designs which could improve end-of-life care in emergency departments. Further research in the area of end-of-life care in emergency settings is recommended.</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:44Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:44Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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