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Articles 1 - 30 of 55
Full-Text Articles in Medicine and Health Sciences
Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis
Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis
Nursing | Senior Theses
Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …
Simplifying Qualitative Case Study Research Methodology: A Step-By-Step Guide Using A Palliative Care Example, Elizabeth M. Miller Mrs, Joanne E. Porter Professor, Michael S. Barbagallo Dr
Simplifying Qualitative Case Study Research Methodology: A Step-By-Step Guide Using A Palliative Care Example, Elizabeth M. Miller Mrs, Joanne E. Porter Professor, Michael S. Barbagallo Dr
The Qualitative Report
Qualitative case study research can be a helpful methodology when conducting health research. However, it can be overlooked or dismissed as a possible methodological choice due to different epistemological positionings by case study theorists and often confusing and contradictory definitions and terminology. Much has been written about case studies, but it takes time to wade through volumes of often philosophically and methodologically dense material to locate a theorist who presents case study research at a depth the novice researcher can understand. Case study research literature may offer a condensed summary of processes but often needs more theoretical detail. Therefore, discerning …
Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko
Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko
Nursing (graduate) Student Scholarship
Background: Over 35% of all deaths in the United States occur in the acute care hospital setting, and 75% of end-of-life (EOL) patients require palliative care. Registered nurses (RNs) with strong palliative care self-efficacy (PCSE) promote positive death experiences for patients and families by minimizing patient suffering and maintaining clinical and ethical standards. Employers can enhance RNs’ PCSE through educational interventions and resources.
Problem: Inpatient acute care hospital RNs lack PCSE because acute care is traditionally curative, and RNs receive limited EOL care education.
Methods: A quality improvement project was conducted. Participants were a convenience sample of RNs …
Improving Advance Directive Documentation In A Primary Care Clinic In The Midwest, Teresa Hagedorn
Improving Advance Directive Documentation In A Primary Care Clinic In The Midwest, Teresa Hagedorn
Doctor of Nursing Practice Scholarly Project
An Abstract of the Scholarly Project by
Teresa Gayle Hagedorn
Advance care planning (ACP) is a continuous communication process linking patients, family members, caregivers, and healthcare providers. Personal values, life goals, and preferences regarding future medical care are significant to every person as we will inevitably reach the end of life. Advance directives (ADs) promote patient autonomy and provide legal documentation of a patient’s wishes for future care. According to the National Institute of Health (2018), only 1 in 3 adults in the United States have a documented AD in their electronic medical records (EMR). This quality improvement project aimed …
Preparedness, Resilience And Unmet Needs Of Informal Caregivers Of Advanced Cancer Patients In A Regional Mission Hospital In Kenya: Qualitative Study, Too Wesley, Faith Lelei, Mary Adam, Pete Halestrap
Preparedness, Resilience And Unmet Needs Of Informal Caregivers Of Advanced Cancer Patients In A Regional Mission Hospital In Kenya: Qualitative Study, Too Wesley, Faith Lelei, Mary Adam, Pete Halestrap
School of Nursing & Midwifery, East Africa
Background: Cancer is the third highest cause of death in Kenya. Eighty percent of cancer cases arrive at advanced stages, when there is nothing that can be done to cure them, and palliative care is the best alternative. Although the majority of end-of-life care in Kenya is provided at home, little is known about the caregivers’ preparedness, resilience and continued unmet needs. The goal of this qualitative study was to explore caregivers’ perceived preparedness, resilience and continued unmet needs in their caregiving role to patients with advanced stages of cancer.
Methods: A purposive sampling method was used to identify and …
Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis
Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis
Nursing | Student Research Posters
Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care based training, with …
Integrating Palliative Care In The Cardiac Surgery Icu, Katherine Rodman
Integrating Palliative Care In The Cardiac Surgery Icu, Katherine Rodman
Walden Dissertations and Doctoral Studies
Over the last decade, patients who remain critically ill but in the chronic stage have become a subset of patients who often remain in the cardiac intensive care unit (CICU) for many months. Palliative care in the ICU has an important role and is well recognized by various studies to alleviate physical symptoms due to invasive treatments, to set patient-centered goals of care, and to provide end-of-life care. This acute care facility does not have guidelines for clinicians to use when introducing and managing palliative care for terminal heart failure patients during long term stays in the ICU. The clinical …
Doing Death Better: Practical Ways For Healthcare Professionals To Care For The Dying Patient And Their Families, Andrea Wilson
Doing Death Better: Practical Ways For Healthcare Professionals To Care For The Dying Patient And Their Families, Andrea Wilson
Undergraduate Honors Theses
Healthcare professionals care for patients with unique personal, cultural, religious, and medical needs, but these needs are not always met in a way that ensures the patient and their families are being treated as unique individuals. This paper first provides an overview of the physiological aspects of dying and how to educate patients and their families regarding expectations in end-of-life. The impacts of the death of a child and a parent were explored, and areas in need of more resources for these individuals were identified. The beliefs and practices of Hindu, Native American, and Islamic cultures were discussed, and lessons …
End-Of-Life Simulation Education, Lucas Farris
End-Of-Life Simulation Education, Lucas Farris
MSN Capstone Projects
In the current healthcare workforce, there exists a lack of comfort and knowledge about providing end-of-life (EOL) care that will only continue to worsen without prompt changes to the delivery of education (Jablonski et al., 2020). The lack of knowledge and comfort expressed in providing EOL care leads to a nurse’s moral and physical difficulty when a patient chooses palliative care or hospice. This is a detriment to patients and should be a consideration for schools of nursing when developing curriculum and clinical activities. By promoting changes in curriculum and the addition of an EOL simulation at the undergraduate level, …
Integration Of The Respiratory Distress Observation Scale For Patients At The End Of Life, Alexandra Mackenzie Starnes
Integration Of The Respiratory Distress Observation Scale For Patients At The End Of Life, Alexandra Mackenzie Starnes
Doctor of Nursing Practice Scholarly Projects
Problem Statement: Dyspnea is a distressing phenomenon experienced frequently in end-of-life patients. Nurses currently rely on their own experiences and observations of other nurses to guide their assessment and treatment of dyspnea. Lack of a standardized tool may lead to inconsistencies and inadequate care.
Purpose: Determine if the implementation of the RDOS will improve the nurses’ ability and self-reported comfort levels to assess and treat respiratory distress in patients at the end of life adequately and consistently.
Methods: A pre-test and post-test design evaluated nurses’ ability and self-reported comfort levels assessing and treating respiratory distress in end-of-life patients. Nurses rated …
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Doctor of Nursing Practice Final Manuscripts
Acute care nurses caring for end-of-life (EOL) patients often feel unprepared for and undereducated about this high-need population. According to current literature, many nurses lack adequate training in providing EOL care. This project aimed to improve symptom management of dying patients by providing acute care nurses education about EOL symptom assessment and medication use for symptom management. The revised Iowa model, which emphasizes clinician involvement, guided this evidence-based practice project. Sixteen acute care nurses received 30-minute in-person education, consisting of instruction in EOL symptom assessment and management via use of the CARES (comfort, airway, restlessness, emotional, self-care) tool and basic …
Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug
Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug
Doctor of Nursing Practice Scholarly Project
As the geriatric population grows rapidly, the importance of utilizing and understanding palliative services continues to rise. Although palliative and hospice care are included in different healthcare courses, misconceptions and lack of knowledge continue to serve as barriers to the utilization of palliative care. The purpose was to assess knowledge, improve palliative care education, and increase understanding of the perspectives of the interdisciplinary team involved in acute patient care. The setting was the telemetry unit in a 300-bed acute care Kansas hospital. A mixed design was utilized with a goal of quality improvement in the use of palliative care. The …
Exploring Moral Permissibility Of Nurse Participation In Limited Resuscitation, Felicia Stokes
Exploring Moral Permissibility Of Nurse Participation In Limited Resuscitation, Felicia Stokes
Electronic Theses and Dissertations
This dissertation offers a novel approach to support nurses when they face conflict between clinicians and families or alternate decision-makers over potentially inappropriate end-of-life goals of care. This dissertation will provide a normative analysis of the moral permissibility of limited resuscitation, with arguments supported by analyses of families’ and nurses’ perspectives and actions in the EoL decision-making process. Limited resuscitation is a cardiopulmonary resuscitation effort where full pharmacologic and mechanical intervention is not used, or the length of the resuscitative effort is shortened. It is typically associated with deception because it is performed without the knowledge of patients and families. …
The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner
The Effectiveness Of A Webinar To Improve Icu Nurses’ Competency In Palliative Care, Justine Kirschner
The Eleanor Mann School of Nursing Student Works
Patients with serious illness lack access to quality patient-centered care despite the growth in palliative care awareness and services. Palliative care is an interdisciplinary care system intended to optimize the quality of life of patients with serious, life-limiting illness and their families. Patients admitted to the intensive care unit (ICU) are facing critical illnesses and can benefit from palliative care integration into their care. This DNP quality improvement (QI) project, grounded in Benner’s Novice to Expert nursing theory, aimed to increase ICU nurse competency in palliative care from novice to competent through a continuing education webinar. The study analyzed nurses’ …
Increase Knowledge And Attitude In End-Of-Life For Long-Term Care Nurses, Lisa Mitchell
Increase Knowledge And Attitude In End-Of-Life For Long-Term Care Nurses, Lisa Mitchell
Walden Dissertations and Doctoral Studies
Nurses are key health professionals in long-term care facilities who have an essential role in providing compassionate care at the end-of-life. The customary education that nurses receive in end-of-life care is inadequate to meet the complex care of dying patients. The purpose of this scholarly project was to implement an evidence-based end-of-life educational program to improve the nursing staff knowledge, attitudes towards care of the dying, and standards in long-term care. The theoretical framework to guide this project is Bandura’s self-efficacy to support the confidence and attitude of nurses caring for the dying. The End-of-Life Nursing Education Consortium (ELNEC) Geriatric …
An Educational Program For Hospice Nurses About End-Of-Life Protocols, Rhonda Coleman
An Educational Program For Hospice Nurses About End-Of-Life Protocols, Rhonda Coleman
Walden Dissertations and Doctoral Studies
Abstract Palliative care is specialized care for people living with a serious illness. This type of care is centered on providing relief from the symptoms and stress of the illness with a primary goal to improve the quality of life for both the patient and the family. A gap in nursing practice was identified in a hospice facility in the South Central United States.; the nurses did not use palliative care or end-of-life (EoL) protocols. This project focused, therefore, on the development of a nursing staff education program for hospice nurses to increase knowledge about the use of EoL protocols. …
Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison
Increasing Knowledge And Comfort Levels Of Icu Nurses In Goals Of Care Discussions Through Palliative Care Education, Stephanie Harrison
Doctor of Nursing Practice Projects
Critical care nurses are tasked with treating patients during the most complex times, typically beginning with aggressive treatment measures and in many cases, transitioning to end-of-life care. According to the literature review, critical care nurses report they frequently provide care that they feel is futile and palliative care resources are underutilized in the intensive care unit. They also report limited education/training and comfort in understanding their role in goals of care conversations and end-of-life care despite their vital role in providing direct patient care. The goal of this project was to implement an education program using the IMPACT-ICU toolkit to …
An Interprofessional Approach To Holistic End-Of-Life., Andrew Aschbacher
An Interprofessional Approach To Holistic End-Of-Life., Andrew Aschbacher
Doctor of Nursing Practice Papers
Purpose: The goal of this Doctor of Nursing Practice (DNP) project was to develop and evaluate an evidence-based clinical practice guideline (EBP) for an interprofessional approach across four end-of-life care domains (1) ethnocentric spiritual wellbeing, (2) mental wellbeing, (3) symptom management, and (4) value-based goals of care. Design and Methods: The Iowa Model for the Development of Evidence-Based Practice guided the development of the practice guideline. A multi-phase literature review was conducted to establish and grade the best evidence. A two-phase evaluation plan was developed. The University of Louisville Institutional Review Board approved the project. Results: In evaluation phase one, …
Improving Rural Emergency Nurses Comfort During Palliative And End-Of-Life Communication, Abbie A. Styes, Mary J. Isaacson
Improving Rural Emergency Nurses Comfort During Palliative And End-Of-Life Communication, Abbie A. Styes, Mary J. Isaacson
College of Nursing Faculty Publications
Background: Emergency nurses (ENs) often care for patients nearing the end of their lives or with life-limiting illnesses. However, ENs are hesitant to initiate palliative or end-of-life (PEOL) discussions because of a lack of comfort with these topics. Many ENs have no formal PEOL communication training which contributes to the lack of comfort with PEOL discussions in the emergency department (ED). Thus, the purpose of this quality improvement project was to determine how PEOL communication training affected rural ENs perceived comfort level during PEOL conversations.
Sample/Setting: A convenience sample of 14 registered nurses working in a rural Northern Plains ED. …
Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon
Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon
The Eleanor Mann School of Nursing Undergraduate Honors Theses
There is little known about the part end-of-life care plays in patient care. This paper examines the role of end-of-life care in the care of a dying patient and consists of findings from a service-learning project with Circle of Life hospice. To be able to effectively care for those in the end stages of life, healthcare professionals must turn away from the curative aspects of medicine, to treating symptoms and improving quality of whatever life remains for the patient. In order to normalize EOL Care and consequently make it more accessible, we must educate our healthcare practitioners regarding the benefits …
The Value Of Family Support At The End Of Life, Hannah Butler
The Value Of Family Support At The End Of Life, Hannah Butler
The Eleanor Mann School of Nursing Undergraduate Honors Theses
There is little research about the role of the family when a patient is dying. This paper examines the role of family support in end-of-life care. This paper consists of the findings from a service learning project with Circle of Life hospice. Patients with family support are more likely to have a DNR, chaplain visit, die at home, and other indicators of quality care. Patients with family support are more likely to receive higher quality care.
End-Of-Life Nursing Consortium To Improve The Gap In Palliative Care, Emma Kroger
End-Of-Life Nursing Consortium To Improve The Gap In Palliative Care, Emma Kroger
DNP Projects
Abstract
Objective: The purpose of this project is to implement a palliative care education intervention with a pre- and post-survey to assess knowledge, emotional preparedness, and confidence in undergraduate nursing students at the University of Kentucky.
Aim: The aim of this project is to address the gap in palliative care education by increasing professional knowledge, emotional preparedness, and confidence levels in regards to palliative care of future nurses at the University of Kentucky.
Background: The terms “hospice” and “palliative” are often used interchangeably in the healthcare setting. However, palliative care focuses on symptom management in all stages of acute, chronic, …
Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith
Improving Palliative And Hospice Knowledge Among Nurses In A Long-Term Care Facility., Kelly Rae Smith
Doctor of Nursing Practice Papers
Background: Early referral and implementation of palliative best-practices in patients with chronic diseases and at the end-of-life (EOL) significantly decreases patient symptom burden, increases quality-of-life, contributes to patient and family satisfaction with care, and reduces healthcare costs. Nurses in long-term care (LTC) are poised to help identify patients appropriate for referral, to provide quality palliative and EOL care, but lack adequate knowledge. Objectives: To determine if a short one-on-one or two-on-one palliative and hospice educational offering can improve (a) knowledge of best-practice palliative and hospice care symptom management techniques (b) the ability of nurses to identify patients appropriate for hospice …
Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd
Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd
Doctor of Nursing Practice Final Manuscripts
Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.
Evidence-Based Practice Intervention: Utilizing the American Geriatrics …
Advance Directives And Intensity Of Care Delivered To Hospitalized Older Adults At The End-Of-Life, Marsha Helen Tyacke, Jill L. Guttormson, Mauricio Garnier-Villarreal, Kathryn Schroeter, Wendy Peltier
Advance Directives And Intensity Of Care Delivered To Hospitalized Older Adults At The End-Of-Life, Marsha Helen Tyacke, Jill L. Guttormson, Mauricio Garnier-Villarreal, Kathryn Schroeter, Wendy Peltier
College of Nursing Faculty Research and Publications
Background
Older adults prefer comfort over life-sustaining care. Decreased intensity of care is associated with improved quality of life at the end-of-life (EOL).
Objectives
This study explored the association between advance directives (ADs) and intensity of care in the acute care setting at the EOL for older adults.
Methods
A retrospective, correlational study of older adult decedents (N = 496) was conducted at an academic medical center. Regression analyses explored the association between ADs and intensity of care.
Results
Advance directives were not independently predictive of aggressive care but were independently associated with referrals to palliative care and hospice; however, …
Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Jasmine Burson Jenkins
Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Jasmine Burson Jenkins
Theses and Dissertations
Background: Critical care nurses (CCNs) provide end-of-life (EOL) care for critically ill patients. CCNs face many obstacles while trying to provide quality EOL care. Some research has been published focusing on obstacles CCNs face while trying to provide quality EOL care; however, research focusing on family behavior obstacles is limited.Objective: To determine if magnitude scores (obstacle item size x obstacle item frequency of occurrence) have changed since previous magnitude score data were first gathered in 1999.Methods: A random geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses (AACN) was surveyed. Responses from quantitative Likert- type items …
Knowledge And Attitudes Of Registered Nurses On Palliative Care, Amy Marpu
Knowledge And Attitudes Of Registered Nurses On Palliative Care, Amy Marpu
Doctor of Nursing Practice Scholarly Project
The purpose of this DNP scholarly project (SP) was to evaluate the knowledge and attitudes of registered nurses (RN) regarding palliative care (PC) before and after an educational presentation. This SP strived to answer these questions: What is the current knowledge in RNs of PC and end of life (EOL) patients before and after the education presentation? What is the anxiety level RNs feel regarding medication administration and symptom management in PC and EOL patients before and after the educational presentation?
A multimethodology, cross-sectional study design was used. The participants were currently enrolled in the RN-BSN program at PSU. These …
End-Of-Life Decision Making In Patients With A Cardiac Device, Jessica Harman
End-Of-Life Decision Making In Patients With A Cardiac Device, Jessica Harman
Jessica Harman
The Lived Experience Of Spiritual Well-Being Amongst Informal Caregivers Of Persons With Dementia On Palliative Care Living At Home, Michael Baumgardner
The Lived Experience Of Spiritual Well-Being Amongst Informal Caregivers Of Persons With Dementia On Palliative Care Living At Home, Michael Baumgardner
Dissertations
Title. The Lived Experience of Spiritual Well-Being Amongst Informal Caregivers of Persons with Dementia on Palliative Care Living at Home.
Purpose.This study explored the lived experience of spiritual well-being amongst informal caregivers of a person with dementia who were living at home and enrolled in palliative care.
Background. Patients with dementia comprise the third leading diagnosis in palliative care patients and many receive informal care from family members. Palliative care improves quality of life in patients and their informal caregivers. However, little is known about spiritual well-being in the setting of caregiving of persons with dementia on palliative care. …
Interventions For Promoting Earlier Enrollment Into Hospice And Palliative Care Among Patients With A Terminal Illness, Jody K. Kampa
Interventions For Promoting Earlier Enrollment Into Hospice And Palliative Care Among Patients With A Terminal Illness, Jody K. Kampa
All Electronic Theses and Dissertations
Background: Although research supports palliative care (PC) to improve symptoms and quality of life for patients with terminal illnesses, these services are underutilized. While 80% of people prefer to die at home, the majority still die in an acute care facility, sometimes receiving aggressive interventions that may increase suffering up until the very end of life. Earlier referral to PC or hospice care can improve symptom management and facilitate end-of-life (EOL) wishes. Purpose: The purpose of this critical review of literature was to identify barriers as well as evidenced-based interventions to promote earlier enrollment into hospice and PC among patients …