scholarly journals 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

2020 ◽  
Vol 26 (4) ◽  
pp. 479
Author(s):  
Rakesh Garg ◽  
Anjani Walia ◽  
KamleshK Sharma ◽  
Smita Das
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Critical Care Nurses ◽  
Perceived Barriers ◽  
Medical Institute ◽  
Life Care

scholarly journals Family Behaviors as Unchanging Obstacles in End-of-Life Care: 16-Year Comparative Data

2020 ◽  
Vol 29 (4) ◽  
pp. e81-e91
Author(s):  
Renea L. Beckstrand ◽  
Jasmine B. Jenkins ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Care Providers ◽  
Over Time

Background Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined. Objective To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time. Methods In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999. Results Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient’s end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design. Conclusions The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers.

Critical Care Nurses’ Suggestions to Improve End-of-Life Care Obstacles

2017 ◽  
Vol 36 (4) ◽  
pp. 264-270 ◽  
Author(s):  
Renea L. Beckstrand ◽  
Kacie Hart Hadley ◽  
Karlen E. Luthy ◽  
Janelle L. B. Macintosh
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care

‘Palliative care equals end-of-life care’: barriers to referral in a paediatric tertiary care centre

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A20.2-A20
Author(s):  
Katherine Twamley ◽  
Paula Kelly ◽  
Finella Craig ◽  
Delia Rizpah Hollowell ◽  
Patricia Mendoza ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Tertiary Care ◽  
Life Care ◽  
Care Centre ◽  
Tertiary Care Centre

530: Education on End-of-Life Care for Pediatric Critical Care Nurses: A Needs Assessment

2020 ◽  
Vol 49 (1) ◽  
pp. 257-257
Author(s):  
Kelley Groves ◽  
Larissa Anglim ◽  
Tensing Maa ◽  
Megan Daniel ◽  
Markita Suttle
Keyword(s):  
Critical Care ◽  
Needs Assessment ◽  
End Of Life ◽  
End Of Life Care ◽  
Critical Care Nurses ◽  
Life Care ◽  
Pediatric Critical Care

Pediatric Cardiac Critical Care Transport and Palliative Care: A Case Series

2020 ◽  
Vol 38 (1) ◽  
pp. 94-97
Author(s):  
Xiomara Garcia ◽  
Elizabeth Frazier ◽  
Janie Kane ◽  
Amber Jones ◽  
Carrie Brown ◽  
...  
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Support ◽  
Care Home ◽  
Case Series ◽  
Life Care ◽  
Cardiac Critical Care ◽  
At Home

Objective: To present our center’s experience with terminal extubation in 3 palliative critical care home transports from the Pediatric Cardiac Intensive Unit. Design: All cases were identified from our Cardiovascular intensive care unit ( CVICU). Patients were terminally ill children with no other surgical or medical option who were transported home between 2014 and 2018, for terminal extubation and end-of-life care according to their families’ wishes. Interventions: The patients were 7, 9 months, and 19 years; and they had very complex and chronic conditions. The families were approached by the CVICU staff during multidisciplinary meetings, where goals of care were established. Parental expectations were clarified, and palliative care team was involved, as well as home hospice was arranged pre transfer. The transfer process was discussed and all the needs were established. All patients had unstable medical conditions, with needs for transport for withdrawal of life support and death at home. Each case needed a highly trained team to support life while in transport. The need of these patients required coordination with home palliative care services, as well as community resources due to difficulty to get in their homes. Conclusions: Transportation of pediatric cardiac critical care patients for terminal extubation at home is a relatively infrequent practice. It is a feasible alternative for families seeking out of the hospital end-of-life care for their critically ill and technology dependent children. Our single-center experience supports the need for development of formal programs for end-of-life critical care transports.

‘Death rounds to support critical care nurses: a qualitative study’

2020 ◽  
pp. bmjspcare-2020-002533
Author(s):  
Keh Kiong Ong ◽  
Chew Lai Sum ◽  
Xuelian Jamie Zhou ◽  
Yeow Leng Chow
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychological Impact ◽  
Structured Interview ◽  
Tertiary Hospital ◽  
Critical Care Nurses ◽  
Life Care ◽  
One To One ◽  
Nurses Perceptions

ObjectiveProviding end-of-life care has a significant psychological impact on critical care nurses. Little is known about whether critical care nurses find death rounds useful as a support system. This study aimed to describe critical care nurses’ perceptions of attending death rounds.MethodsThis study was conducted using a qualitative descriptive design, using one-to-one audio-recorded interviews. The study was conducted at a 20-bed medical intensive care unit in a 1200-bed public tertiary hospital in Singapore. One-to-one interviews were conducted with 14 nurses using a semi-structured interview guide. Data was analysed using thematic analysis.ResultsCritical care nurses valued attending death rounds. They found death rounds to be an outlet to express themselves and remember patients, to draw and give peer support, to build nursing and interprofessional cohesiveness and to learn to improve palliative care. The death rounds were optimal when they felt safe to share, when there was a good facilitator, when the hierarchy was flat and when the audience was interdisciplinary. The barriers to a successful death round were the rounds being too formal, timing and not knowing the patients.ConclusionDeath rounds are a viable way to support critical care nurses in providing end-of-life care.

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