12.00
Hdl Handle:
http://hdl.handle.net/10755/162714
Type:
Presentation
Title:
Assessing End of Life Care Practices in Patients with Multiple Trauma
Abstract:
Assessing End of Life Care Practices in Patients with Multiple Trauma
Conference Sponsor:Emergency Nurses Association
Conference Year:2001
Author:Shreve, Wendy Sue, MSN, RN, CNS, CCRN, CS
P.I. Institution Name:St. Vincent Mary Medical Center
Contact Address:2213 Cherry Street, Toledo, OH, 43608, USA
Contact Telephone:(419) 251-4471
Purpose: To describe the documentation regarding end of life (EOL) care and test one relational statement from the middle range theory on a peaceful EOL that was developed from a standard of care by nurses in Norway. The theory focuses not on the final instance of dying but on the contribution nurses can make toward a peaceful and meaningful death for the patients. Design: Retrospective medical record review of calendar year 1998 of the trauma patient deaths that occurred any time after arrival to the emergency department. Setting: Records were from a Level I Trauma Center at a large urban community hospital. Sample: 88 deaths with 73 charts were available for review. The sample mean age was 41.67 years (SD +/- 26.67, range 1-94) and was predominantly male (72.9%). Methodology: Documentation relative to the third relational statement of Ruland and Moore's Middle Range Theory of a Peaceful End of Life was reviewed. There are three factors that contribute to the patient?s experience of dignity and respect. They are: 1) being attentive to the patient's expressed wishes, needs, and preferences; 2) including the patient and family in patient care decision making; and 3) treating the patient with empathy, respect and dignity. Results: Attention to spiritual needs was documented for 65.8% of patients/families; 43.8% had documentation that death was the expected outcome, yet 60% of the patients died without being resuscitated. An EOL conversation with health care providers was reported by 52% of families, with 6% of patients meeting with their physician. One-half of the patients had CPR at some point in their care, with 9.6% having CPR twice, 2.7% having it 3 times and 1.4% had CPR 4 times. A total of 64% of patients had fewer than 3 billable procedures at time of death. CPR was correlated with younger age (r = .266, p = .02). Over one-half (57%) of patients died while aggressive care was in progress and none of the records had any documentation of conflict between the family and a health care worker. Nurses documented EOL care discussions by other health care providers more frequently than their own interactions. Conclusions: Most were treated with respect and dignity through evidence of shared decision making and spiritual support consistent with the middle range theory. The low number of repeat CPR attempts and other billable procedures may indicate that use of extreme measures were in accord with family wishes. Upon completion of this poster review, the participant will be able to: 1) Discuss family involvement in the end of life care of trauma patients; and 2) List one issue in end of life care for trauma patients. [Research Poster Presentation]
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.titleAssessing End of Life Care Practices in Patients with Multiple Traumaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162714-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Assessing End of Life Care Practices in Patients with Multiple Trauma</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">2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Shreve, Wendy Sue, MSN, RN, CNS, CCRN, CS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Vincent Mary Medical Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2213 Cherry Street, Toledo, OH, 43608, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(419) 251-4471</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">wsshreve@buckeye-express.com</td></tr><tr><td colspan="2" class="item-abstract">Purpose: To describe the documentation regarding end of life (EOL) care and test one relational statement from the middle range theory on a peaceful EOL that was developed from a standard of care by nurses in Norway. The theory focuses not on the final instance of dying but on the contribution nurses can make toward a peaceful and meaningful death for the patients. Design: Retrospective medical record review of calendar year 1998 of the trauma patient deaths that occurred any time after arrival to the emergency department. Setting: Records were from a Level I Trauma Center at a large urban community hospital. Sample: 88 deaths with 73 charts were available for review. The sample mean age was 41.67 years (SD +/- 26.67, range 1-94) and was predominantly male (72.9%). Methodology: Documentation relative to the third relational statement of Ruland and Moore's Middle Range Theory of a Peaceful End of Life was reviewed. There are three factors that contribute to the patient?s experience of dignity and respect. They are: 1) being attentive to the patient's expressed wishes, needs, and preferences; 2) including the patient and family in patient care decision making; and 3) treating the patient with empathy, respect and dignity. Results: Attention to spiritual needs was documented for 65.8% of patients/families; 43.8% had documentation that death was the expected outcome, yet 60% of the patients died without being resuscitated. An EOL conversation with health care providers was reported by 52% of families, with 6% of patients meeting with their physician. One-half of the patients had CPR at some point in their care, with 9.6% having CPR twice, 2.7% having it 3 times and 1.4% had CPR 4 times. A total of 64% of patients had fewer than 3 billable procedures at time of death. CPR was correlated with younger age (r = .266, p = .02). Over one-half (57%) of patients died while aggressive care was in progress and none of the records had any documentation of conflict between the family and a health care worker. Nurses documented EOL care discussions by other health care providers more frequently than their own interactions. Conclusions: Most were treated with respect and dignity through evidence of shared decision making and spiritual support consistent with the middle range theory. The low number of repeat CPR attempts and other billable procedures may indicate that use of extreme measures were in accord with family wishes. Upon completion of this poster review, the participant will be able to: 1) Discuss family involvement in the end of life care of trauma patients; and 2) List one issue in end of life care for trauma patients. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:54Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:54Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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