Critical Care Nurses' Knowledge, Practice, Obstacles and Helpful Measures Towards Palliative Care for Critically Ill Patients

Abstract

Palliative care (PC) is a specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain and stress of serious illness. The aim of the study is to assess critical care nurses' knowledge, practice, Obstacles and helpful measures toward palliative care for critically ill patients. The research design of this study was a descriptive design. It was conducted at Medical Intensive Care Unit (ICU) at Tanta University Hospital and oncology ICU at oncology institute, Tanta, Egypt. Three tools were used for collecting data. Tool I is a structured interview questionnaire sheet to collect data about nurses' sociodemographic data and knowledge. Tool II is an observational checklist for nurses' practice regarding palliative care and tool III is nurses' perception of obstacles and helpful measures towards palliative care for critically ill patients. The results of the study reported that more than three quarter (77.1%) and (48.6%) of critical care nurses in medical and oncology ICUs, respectively, had unsatisfactory score of knowledge. More than half (51.4%) and 25.7% of nurses in Medical and Oncology ICUs respectively had poor practice while more than one third (34.3%) and 40% of nurses in medical and oncology department respectively had good practice score. From this paper, it was concluded that nurses in intensive care units at the Tanta University Hospital had unsatisfactory knowledge and practice regarding palliative care which is considered as an important aspect of improving quality of care. The most obstacles for providing palliative care are "not enough time to provide quality end of life. It was recommended that educational and inservice training programs should be conducted by the nursing personal in both hospital and intensive care settings about palliative care.

A descriptive study to assess the knowledge, attitude, practices, perceived barriers, and support regarding palliative care and end-of-life care among critical care nurses of tertiary care medical institute

“…Knowledge was categorized as per the review of literature as poor <10 scores (<50% of total score), satisfactory 10–13 scores (50%–65% of total score), good 14–17 scores (66%–85% of total score), and excellent >17 scores (>85% of total score). [ 1 2 3 6 7 ]…”

“…The practice was categorized by the researcher as per the review of literature, as satisfactory >20 marks (>75% of total score) and poor ≤20 marks (≤75% of total score). [ 1 2 3 6 7 ]…”

“…The involvement of nurses in critical decision-making along with adequate training in palliative and EOLC needs to be emphasized. [ 4 5 6 7 ] However, there are not sufficient data from critical care nursing personnel with regard to the understanding of palliative and EOLC.…”

Critical Care Nurses Knowledge, Practice, Facilitators, and Barriers of Palliative Care: A Scoping Review

“…Kamal, Wolf [32] reported that inadequate preparedness of the nurses of both knowledge and practice sides was one of the most important obstacles was consistent with most of the reviewed articles [5,29,33], as they con rmed the importance of education on the practice level and provision of care. Moreover, this literature [30] has proved that inadequate timing is another important barrier to providing palliative care, as it prevents the nurses from providing the complete care practices that terminally ill patients require, and this was consistent with [34]. Others found the improper design of the ICU is another barrier that prevents nurses from providing the optimum palliative care [12].…”

“…Moreover, some studies found that clinical practice needed to be stronger [5,7]. Conversely, some studies have reported good and effective clinical practice in providing palliative care [30]. However, some studies have pointed out that practice is highly affected by the level of knowledge since the nurses who had good knowledge showed ideal and correct palliative care [5,18,31].…”