Emergency Nurses' Perceptions of Obstacles and Supportive Behaviors in End-of-Life Care

Heaston, Sondra; Beckstrand, Renea L.; Bond, A. Elaine; Palmer, Sheri P.

doi:10.1016/j.jen.2006.07.013

Cited by 64 publications

(49 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1][2][3][4] Nurses working in these areas identify the goals of PEOLB care to include good pain management, reducing patient suffering, facilitating a dignified death, and effective communication between the health care team, the patient, and the family. [5][6][7][8] Additionally, they report obstacles to the PEOLB care they provide including lack of communication among physicians, nurses, and families; lack of a defined treatment plan; discomfort with death and dying; unnecessary prolongation of life; and lack of awareness of end-of-life practices and resources. [6][7][8] In spite of the advancements in understanding the beliefs and experiences of nurses providing adult PEOLB care, we are unaware of equivalent studies that focus specifically on pediatric nurse perspectives of PEOLB care.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8] Additionally, they report obstacles to the PEOLB care they provide including lack of communication among physicians, nurses, and families; lack of a defined treatment plan; discomfort with death and dying; unnecessary prolongation of life; and lack of awareness of end-of-life practices and resources. [6][7][8] In spite of the advancements in understanding the beliefs and experiences of nurses providing adult PEOLB care, we are unaware of equivalent studies that focus specifically on pediatric nurse perspectives of PEOLB care. We therefore surveyed pediatric nurses in a freestanding children's hospital regarding their PEOLB beliefs and experiences in caring for dying children and their families.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Nurses' Individual and Group Assessments of Palliative, End-of-Life, and Bereavement Care

Tubbs‐Cooley

Santucci

Kang

et al. 2011

Journal of Palliative Medicine

View full text Add to dashboard Cite

Background: Although pediatric nurses working in children's hospitals often provide care to dying children, little is known about their palliative care beliefs and experiences as individuals or members of groups within the hospital. Objective: To describe pediatric nurses' ratings of palliative care goals and problems, as individuals and members of clusters of nurses with similar views, and nurses' degree of collaboration with an inpatient palliative care team across hospital units. Method: A cross-sectional survey of nurses at a freestanding children's hospital in 2005. Results: Nurses rated the most important goals as managing pain, maintaining the child's quality of life, and improving communication. Commonly cited problems were lack of opportunity to debrief after a patient's death, uncertainty about the goals of care, and the health care team's reluctance to discuss hospice with family. Based on individual views about goals and problems, nurses clustered into 5 groups that differed in terms of the adamancy of their views and the scope of the goals and problems they considered important or significant. The hospital unit was the most important factor in predicting nurses' degree of collaboration with the palliative care team even after accounting for individual characteristics. Conclusions: Pediatric nurses broadly endorse both the importance of palliative care goals and the presence of problems yet perceive the importance of these goals and problems differently. Further, they vary in their level of collaborative practice with a palliative care team in ways that should be accounted for when planning and implementing palliative care programs.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pediatric Nurses' Individual and Group Assessments of Palliative, End-of-Life, and Bereavement Care

Tubbs‐Cooley

Santucci

Kang

et al. 2011

Journal of Palliative Medicine

View full text Add to dashboard Cite

show abstract

“…ED physicians have little information at their disposal to guide their decisions with respect to end-of-life care and cannot provide the privacy and support required by dying patients and their families and caregivers. 1,3,4 Many patients present to the ED seeking symptom relief, caregiver reassurance, and support; others are forced to visit the ED because death is imminent and they are unable or unwilling to die at home. 1,3,5 Fewer ED visits during the last month of life is identified as a potential indicator of quality of care during the end of life.…”

Section: Introductionmentioning

confidence: 99%

Can the Introduction of an Integrated Service Model to an Existing Comprehensive Palliative Care Service Impact Emergency Department Visits among Enrolled Patients?

Lawson

McIntyre²,

Field³

et al. 2009

Journal of Palliative Medicine

View full text Add to dashboard Cite

Purpose-Fewer emergency department (ED) visits may be a potential indicator of quality of care during the end of life. Receipt of palliative care, such as that offered by the adult Palliative Care Service (PCS) in Halifax, Nova Scotia, is associated with reduced ED visits. In June 2004, an integrated service model was introduced into the Halifax PCS with the objective of improving outcomes and enhancing care provider coordination and communication. The purpose of this study was to explore temporal trends in ED visits among PCS patients before and after integrated service model implementation.Methods-PCS and ED visit data were utilized in this secondary data analysis. Subjects included all adult patients enrolled in the Halifax PCS between January 1, 1999 and December 31, 2005, who had died during this period (N = 3221). Temporal trends in ED utilization were evaluated dichotomously as preintegration or postintegration of the new service model and across 6-month time blocks. Adjustments for patient characteristics were performed using multivariate logistic regression.Results-Fewer patients (29%) made at least one ED visit postintegration compared to the preintegration time period (36%, p < 0.001). Following adjustments, PCS patients enrolled postintegration were 20% less likely to have made at least one ED visit than those enrolled preintegration (adjusted OR 0.8; 95% confidence interval 0.6-1.0).Conclusion-There is some evidence to suggest the introduction of the integrated service model has resulted in a decline in ED visits among PCS patients. Further research is needed to evaluate whether the observed reduction persists.

show abstract

“…Another major barrier was in having to deal with the anger of families, as reported in other studies (Beckstrand & Kirschoff, 2005;Beckstrand, Smith, Heaston, & Bond, 2008;Heaston, Beckstrand, Bond, & Palmer, 2006). However, a number of experienced participants described their commitment to persevere in aiding to resolve or clarify misconceptions, and work through emotions until desirable responses or behaviours were achieved.…”

Section: Can Choose How To Spend a Good Majority Of My Day There'smentioning

confidence: 92%

Oncology nurses’ perceptions of their relations with family members in an ambulatory cancer care setting: A mixed methods study

Lobchuk

Udod²

2011

CONJ

View full text Add to dashboard Cite

Emergency Nurses' Perceptions of Obstacles and Supportive Behaviors in End-of-Life Care

Cited by 64 publications

References 10 publications

Pediatric Nurses' Individual and Group Assessments of Palliative, End-of-Life, and Bereavement Care

Pediatric Nurses' Individual and Group Assessments of Palliative, End-of-Life, and Bereavement Care

Can the Introduction of an Integrated Service Model to an Existing Comprehensive Palliative Care Service Impact Emergency Department Visits among Enrolled Patients?

Oncology nurses’ perceptions of their relations with family members in an ambulatory cancer care setting: A mixed methods study

Contact Info

Product

Resources

About