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Frequency And Magnitude Of Obstacles And Helpful Behavior Items In End-Of-Life Care As Perceived By Nurses Working In Critical Access Hospitals, Shalyn C. Larsen

Theses and Dissertations

Background: Twenty percent of Americans live in rural areas where most of their healthcare is provided in Critical Access Hospitals (CAHs). It is unknown how frequently obstacle and helpful behavior items occur in End-of-Life (EOL) care in CAHs. Objectives: To determine the frequency of occurrence scores of obstacle and helpful behavior items in providing EOL care in CAHs. To also determine which obstacles and helpful behaviors have the greatest or least impact on EOL care based on the magnitude scores. Methods: A questionnaire was sent to nurses working in 39 CAHs in the United States. Nurse participants were asked to …

Critical Access Hospital Nurses' Perceptions Of Obstacles And Helpful Behaviors In End-Of-Life Care, Trissa Michelle Lyman

Theses and Dissertations

Background: The Critical Access Hospitals (CAHs) system was developed to bring health care to rural populations. Although CAHs lack equipment and resources, CAH nurses still provide end-of-life (EOL) care to critically-ill and dying patients. Objectives: To determine the largest and smallest ranked obstacles and helpful behaviors to providing EOL care to rural patients as perceived by CAH nurses. Also, to determine how CAH nurses' perceptions of obstacles and helpful behaviors to providing EOL care compare to that of their urban counterparts. Methods: A cross-sectional, nationally representative sample of nurses working in 39 CAHs were sent a questionnaire. Nurse participants were …

Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Renea L. Beckstrand, Jasmine B. Jenkins, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

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 …

Critical Care Nurses’ Qualitative Reports Of Experiences With Family Behaviors As Obstacles In End-Of-Life Care, Renea L. Beckstrand, Caitlin Mallory, Janelle L. B. Macintosh, Karlen E. Luthy

Faculty Publications

Background: Critical care nurses (CCNs) frequently provide end-of-life (EOL) care for critically ill patients. Critical care nurses may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care.

Objectives: We wanted to gather firsthand experiences of CCNs regarding working with families of dying patients. We then wanted to determine the predominant obstacle themes noted when CCNs …

Critical Care Nurses’ Suggestions To Improve End-Of-Life Care Obstacles: Minimal Change Over 17 Years, Renea L. Beckstrand, Kacie Hart Hadley, Karlen E. Luthy, Janelle L. B. Macintosh

Faculty Publications

Background: Critical-care nurses (CCNs) provide end-of-life (EOL) care on a daily basis as 1 in 5 patients dies while in intensive care units. Critical-care nurses overcome many obstacles to perform quality EOL care for dying patients.

Objectives: The purposes of this study were to collect CCNs’ current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998.

Methods: A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2000 members of the American Association of Critical-Care Nurses. One of 3 qualitative questions …

Critical Care Nurses’ Stories Of Eol Care Obstacles, Robin Grigg, Beckstrand Renea

Journal of Undergraduate Research

The purpose of this project was to discover critical care nurses’ perspectives of obstacles in providing end-of-life (EOL) care to patients. Because 20% of Americans die in an Intensive Care Unit (ICU) (CDC, 2011), EOL care is a vital component of critical care nursing. Therefore, discerning and overcoming obstacles to EOL care is necessary in order for critical care nurses to provide quality EOL care. Additionally, The National Institute of Nursing Research’s strategic plan lists five areas of focus, the third being EOL care, emphasizing the need for EOL care research (NINR, 2014).

Rural Emergency Nurses’ Suggestions For Improving End-Of-Life Care, Renea L. Beckstrand, Kelly E. Smith, Karlen E. (Bethy) Luthy, Janelle L. B. Macintosh

Faculty Publications

Introduction: Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments.

Methods: A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska. One item asked nurses to identify …

Critical-Care Nurses' Suggestions To Improve End-Of-Life Care Obstacles: Minimal Change Over 17 Years, Kacie Hart Hadley

Theses and Dissertations

Background: Critical-care nurses (CCN) provide end-of life (EOL) care on a daily basis as one in five patients dies while in Intensive Care Units (ICU). CCNs overcome many obstacles to perform quality EOL care for dying patients. Objectives: The purposes of this study were to collect CCNs' current suggestions for improving EOL care and determine if EOL care obstacles have changed by comparing results to data gathered in 1998. Methods: A 72-item questionnaire regarding EOL care perceptions was mailed to a national, geographically dispersed, random sample of 2,000 members of the American Association of Critical-Care Nurses. Nurses were asked for …

Critical Care Nurses' Perceptions Of End-Of-Life Care: Comparative 17-Year Data, Nicole Lamoreaux

Theses and Dissertations

BACKGROUND: Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end-of-life (EOL). Providing high quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made over the last 17 years.
OBJECTIVE: To determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether or not meaningful changes have occurred since data were first gathered in …

Rural Emergency Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Kelly Elizabeth Smith

Theses and Dissertations

Introduction: In 2010, of the 129 million visits to the emergency department (ED), 240,000 resulted in the patient dying or being pronounced dead on arrival. This number is likely to continue to increase as a significant portion of the American population ages and seeks care in the ED. Though care in the ED is focused on saving lives, death cannot always be prevented. Consequently, nurses face many barriers to providing quality end-of-life (EOL) care in the ED when death occurs. The purpose of this study was to identify suggestions emergency nurses have to improve EOL care specifically in rural ED's. …

National Study Of Neonatal Intensive Care Unit Nurse’S Perceptions Of Obstacles And Supportive Behaviors In End-Of-Life Care, Katie Hillary, Renea Beckstrand

Journal of Undergraduate Research

Neonatal end-of-life (EOL) care supports a peaceful and dignified death for the infant as well as provision of loving support to the family (National Association of Neonatal Nurses, 2010). Infant mortality in the U.S. is 6.05 infant deaths per 1,000 births (MacDorman, Hoyert, & Matthews, 2013). Due to this infant mortality rate, Neonatal Intensive Care Unit (NICU) nurses need to understand how to provide EOL care to patients and families. NICU nurses who care for dying infants are faced with unique EOL care obstacles and challenges. EOL nursing care for infants not only includes the patient, but also the family. …

Oncology Nurses' Obstacles And Supportive Behaviors In End-Of-Life Care: Providing Vital Family Care, Renea L. Beckstrand, Joan Collette, Lynn Callister, Karlen E. (Beth) Luthy

Faculty Publications

Purpose/Objectives: To determine the impact of obstacles and supportive behaviors in end-of-life (EOL) care as perceived by hospital-based oncology nurses.

Design: A 69-item mailed survey.

Setting: National random sample.

Sample: 1,005 nurse members of the Oncology Nursing Society who had provided EOL care for patients with cancer.

Methods: Three mailings yielded 380 usable responses from 912 eligible respondents, resulting in a 42% return rate.

Main Research Variables: Size and frequency of EOL care obstacles and supportive behaviors for patients with cancer in a hospital setting.

Findings: Results of this research demonstrate the need for more EOL education and help in …

Emergency Department Nurses' Suggestions For Improving End-Of-Life Care, Robert D. Wood

Theses and Dissertations

Introduction: Death is not an uncommon outcome for patients who seek immediate care in an emergency department. Although death is common in the emergency department there is little literature regarding end-of-life care in the emergency department. The purpose of this research study is to determine what changes emergency nurses would suggest to improve end-of-life care for dying patients and their families in emergency departments.

Background: A national, geographically dispersed, random sample of 1000 emergency nurses were sent a questionnaire entitled, "Emergency Nurses' Perceptions of End-of-Life Care." Inclusion criteria included nurses who were members of the Emergency Nurses Association, could read …

The Last Frontier: Rural Emergency Nurses' Perceptions Of End-Of-Life Care, Virginia Claudia Giles

Theses and Dissertations

Introduction: Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers to providing end-of-life (EOL) care. This study was completed to discover what the size, frequency, and magnitude of obstacles were in providing EOL care in rural emergency departments as perceived by rural emergency nurses.

Methods: A 58-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived barriers to providing EOL care in rural emergency departments. …

Care Of The Dying Child: Pediatric Icu Nurses’ Perceptions Of Obstacles And Supportive Behaviors In End-Of-Life Care, Renea L. Beckstrand, Lynn Clark Callister, Barbara L. Mandleco, Nicole L. Rawle

Faculty Publications

Each year 55,000 children die in the United States. The vast majority of children’s deaths, 75 – 85%, occur in hospital settings with most in pediatric intensive care units. Oftentimes, a nurse is at the bedside of the dying child. Determining the barriers and supportive behaviors in pediatric end-of-life (EOL) care is needed.

Oncology Nurses’ Perceptions Of Obstacles And Supportive Behaviors In End-Of-Life Care, Renea L. Beckstrand, A. Elaine Bond, Lynn Clark Callister, Josie Moore

Faculty Publications

Cancer accounts for one in four deaths in the United States. Oncology nurses care for dying patients on a daily basis. Research on specific obstacles that impede and supportive behaviors that help the delivery of end-of-life (EOL) care is limited.

Emergency Nurses’ Perceptions Of Size, Frequency, And Magnitude Of Obstacles And Supportive Behaviors In End-Of-Life Care, Renea L. Beckstrand, Michelle D. Smith, Sondra Heaston, A. Elaine Bond

Faculty Publications

Introduction: Emergency nurses care for dying patients daily. The process of dying in an emergency department can be complicated. Research on specific obstacles that impede the delivery of end-of-life care in emergency departments and behaviors that support it is limited.

Methods: A 70-item questionnaire was mailed to randomly selected ENA members. Subjects were asked to rate items on the size, frequency, and manitude of obstacles and supportive behaviors that relate to end-of-life care for ED patients.

Results:

The perceived obstacles with the greatest magnitude were as follows: (a) ED nurses’ work loads being too high to allow adequate time for …

Emergency Nurses' Perceptions Of Obstacles And Supportive Behaviors In End-Of-Life Care, Sondra Heaston, Renea L. Beckstrand, A. Elaine Bond, Sheri P. Palmer

Faculty Publications

Introduction: Little is known about emergency nurses' perceptions of either obstacles or supportive behaviors for providing end-of life (EOL) care to dying patients. The purpose of this study was to determine the perceived obstacles and supportive behaviors in providing EOL care to dying patients in emergency departments.

Methods: In this survey research, a 73-item questionnaire regarding EOL care was mailed to a geographically dispersed national random sample of 300 members of the Emergency Nurses Association. Descriptive statistics were calculated for the 54 Likert-type items and demographic items. Two open-ended questions were analyzed using content analysis.

Results: Returns after 3 mailings …

Providing A "Good Death": Critical Care Nurses' Suggestions For Improving End-Of-Life Care, Renea L. Beckstrand, Lynn Clark Callister, Karin T. Kirchhoff

Faculty Publications

• Background Providing appropriate end-of-life care has become a primary concern of nurses and the public. The highly technological critical care environment may not facilitate such care.
• Objective To collect suggestions from critical care nurses for improving end-of-life care in intensive care units.
• Methods A geographically dispersed, random sample of 1409 members of the American Association of Critical-Care Nurses was sent a 72-item survey on perceptions of end-of life care. The survey included a request for suggestions on ways to improve end-of life care.
• Results Of the 861 critical care nurses whoo responded to the survey, 485 offered 530 suggestions for …

Analysis Of End-Of-Life Content In Critical Care Nursing Textbooks, Karin T. Kirchhoff, Renea L. Beckstrand, Prashanth Reddy Anumandla

Faculty Publications

Nurses have identified a need for improving their knowledge and skills in providing end-of-life care. Critical care nursing textbooks can serve as an important source of information on end-of-life care for critical care nurses. Hence, an analysis of end-of-life content in 14 critical care nursing textbooks was conducted. Critical care nursing textbooks used for review were published in 1995 or later and identified from the libraries at the University of Wisconsin-Madison and Brigham Young University. The end-of-life content areas identified by the American Association of Colleges of Nursing (AACN), under which the AACN end-of-life competencies for undergraduate nursing students can …