ICU Bedside Nurses' Involvement in Palliative Care Communication: A Multicenter Survey

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• 作者：Wendy G. Anderson ; MD ; MS^a ; ^{Wendy.Anderson@ucsf.edu" class="auth_mail" title="E-mail the corresponding author} ; Kathleen Puntillo ; RN ; PhD ; FAAN ; FCCM^b ; Deborah Boyle ; RN ; MSN ; FAAN ; AOCNS^c ; Susan Barbour ; RN ; MS ; WOCN ; ACHPN^d ; Kathleen Turner ; RN ; CHPN ; CCRN-CMC^d ; Jenica Cimino ; BA^a ; Eric Moore ; RN ; MBA ; NEA-BC^e ; Janice Noort ; RN ; NP ; MS ; ACHPN^e ; John MacMillan ; MD^e ; Diana Pearson ; RN ; MSN ; CCRN^e ; Michelle Grywalski ; RN ; BSN ; CCRN^c ; Solomon Liao ; MD^c ; Bruce Ferrell ; MD^f ; Jeannette Meyer ; RN ; MSN ; CCRN ; CCNS ; PCCN ; ACHPN^f ; Edith O'Neil-Page ; RN ; MSN ; AOCNS^f ; Julia Cain ; RN ; MSN ; ANP^g ; Heather Herman ; RN ; MS ; ANP^g ; William Mitchell ; MD^g ; Steven Pantilat ; MD ; FAAHPM ; SFHM^a
• 关键词：Critical care nursing ; family ; palliative care ; interdisciplinary communication
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：51
• 期：3
• 页码：589-596.e2
• 全文大小：161 K

文摘

Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses.

Objectives

To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication.

Methods

A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via e-mail in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, U.S.

Results

The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%).

Conclusion

ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.