Nurses' Beliefs About Palliative Care Practices in a University Hospital Setting

2.50
Hdl Handle:
http://hdl.handle.net/10755/165694
Category:
Abstract
Type:
Presentation
Title:
Nurses' Beliefs About Palliative Care Practices in a University Hospital Setting
Author(s):
Nelson-Marten, P.
Author Details:
P. Nelson-Marten, University of Colorado, Denver, Colorado, USA
Abstract:
Significance. Problems exist in the care of patients near the end of life and arise out of a lack of the identification of patients as actively dying on the part of health care professionals. Failure to evaluate the appropriateness of invasive and burdensome interventions on the basis of a patient’s prospects for recovery often occurs. These omissions preclude a transition away from curative treatment, and thus result in an inadequate provision of palliative care. It is often common for nurses in the acute care setting to experience conflict in the care of patients who are transitioning from curative to palliative care. As primary care providers, nurses often get caught in the middle in supporting patients and families in transitioning to dying while needing to carry out protocols that are curative in nature. Problem and Purpose. The purpose of this study is to describe the care that is currently being provided to patients at University of Colorado Hospital (UCH) who are actively dying. The specific aims are to: 1) examine the methods UCH nurses use to determine that a patient is actively dying, 2) identify the processes by which transition from curative to palliative care is effected, and 3) to identify nurses’ knowledge and attitudes about palliative care at UCH. Theoretical/Scientific Framework. The study’s theoretical framework is based on the results of the SUPPORT study (1995) and the WHO palliative care definition (1990). Methods. A mixed method qualitative and quantitative descriptive study was conducted at UCH. Qualitative data were collected from a nursing focus group, analyzed for common themes and reviewed by an expert panel. A quantitative knowledge and attitudes survey, developed from the qualitative data analysis, was administered to all UCH nurses and other healthcare professionals (return rate n= 342). A medical record audit examined the characteristics of all deaths (n = 215) at UCH during 1997. Data Analysis/Evaluation. Six common themes were derived from the nursing focus group data. Survey and medical record audit data were analyzed using descriptive statistics, frequencies and tests of association. Findings and Implications. Most nurses believed that end of life care could be improved. Medical record data findings show that the time from hospital admission to do not resuscitate (DNR) order was three days, the median time between DNR order and death was one day, and 52% of patients had documentation of advanced directives. A failure to provide appropriate care for hospitalized patients near the end of life was prevalent. Standard criteria for assessing patients who are actively dying and the accompanying requirement for a transition to palliative care were found to be lacking. The need exists to develop standard palliative care assessment criteria. Development of protocols to manage symptoms is integral to the improvement of quality of care at the end of life.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleNurses' Beliefs About Palliative Care Practices in a University Hospital Settingen_GB
dc.contributor.authorNelson-Marten, P.en_US
dc.author.detailsP. Nelson-Marten, University of Colorado, Denver, Colorado, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165694-
dc.description.abstractSignificance. Problems exist in the care of patients near the end of life and arise out of a lack of the identification of patients as actively dying on the part of health care professionals. Failure to evaluate the appropriateness of invasive and burdensome interventions on the basis of a patient’s prospects for recovery often occurs. These omissions preclude a transition away from curative treatment, and thus result in an inadequate provision of palliative care. It is often common for nurses in the acute care setting to experience conflict in the care of patients who are transitioning from curative to palliative care. As primary care providers, nurses often get caught in the middle in supporting patients and families in transitioning to dying while needing to carry out protocols that are curative in nature. Problem and Purpose. The purpose of this study is to describe the care that is currently being provided to patients at University of Colorado Hospital (UCH) who are actively dying. The specific aims are to: 1) examine the methods UCH nurses use to determine that a patient is actively dying, 2) identify the processes by which transition from curative to palliative care is effected, and 3) to identify nurses’ knowledge and attitudes about palliative care at UCH. Theoretical/Scientific Framework. The study’s theoretical framework is based on the results of the SUPPORT study (1995) and the WHO palliative care definition (1990). Methods. A mixed method qualitative and quantitative descriptive study was conducted at UCH. Qualitative data were collected from a nursing focus group, analyzed for common themes and reviewed by an expert panel. A quantitative knowledge and attitudes survey, developed from the qualitative data analysis, was administered to all UCH nurses and other healthcare professionals (return rate n= 342). A medical record audit examined the characteristics of all deaths (n = 215) at UCH during 1997. Data Analysis/Evaluation. Six common themes were derived from the nursing focus group data. Survey and medical record audit data were analyzed using descriptive statistics, frequencies and tests of association. Findings and Implications. Most nurses believed that end of life care could be improved. Medical record data findings show that the time from hospital admission to do not resuscitate (DNR) order was three days, the median time between DNR order and death was one day, and 52% of patients had documentation of advanced directives. A failure to provide appropriate care for hospitalized patients near the end of life was prevalent. Standard criteria for assessing patients who are actively dying and the accompanying requirement for a transition to palliative care were found to be lacking. The need exists to develop standard palliative care assessment criteria. Development of protocols to manage symptoms is integral to the improvement of quality of care at the end of life.en_GB
dc.date.available2011-10-27T12:23:16Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:23:16Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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