PALLIATIVE CARE PROFESSIONAL DEVELOPMENT FOR CRITICAL CARE NURSES: A MULTICENTER PROGRAM

被引:36
|
作者
Anderson, Wendy G. [1 ,2 ]
Puntillo, Kathleen [3 ]
Cimino, Jenica [1 ,2 ]
Noort, Janice [4 ]
Pearson, Diana [4 ]
Boyle, Deborah [5 ]
Grywalski, Michelle [5 ]
Meyer, Jeannette [6 ]
O'Neil-Page, Edith [6 ]
Cain, Julia [9 ]
Herman, Heather [9 ]
Barbour, Susan [10 ]
Turner, Kathleen [10 ]
Moore, Eric [4 ]
Liao, Solomon [5 ]
Ferrell, Bruce [8 ]
Mitchell, William [9 ]
Edmonds, Kyle [9 ]
Fairman, Nathan [4 ]
Joseph, Denah [10 ]
MacMillan, John [4 ]
Milic, Michelle M. [11 ]
Miller, Monica [4 ]
Nakagawa, Laura [4 ]
O'Riordan, David L.
Pietras, Christopher [6 ,7 ]
Thornberry, Kathryn [9 ]
Pantilat, Steven Z. [1 ,2 ]
机构
[1] Univ Calif San Francisco, Div Hosp Med, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Palliat Care Program, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Sch Nursing, Dept Phys, San Francisco, CA 94143 USA
[4] Univ Calif Sacramento, Davis Med Ctr, Sacramento, CA USA
[5] Univ Calif Irvine, Irvine Hlth, Orange, CA 92668 USA
[6] Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA
[7] Univ Calif Los Angeles, Hosp Sect Palliat Care, Div Gen Internal Med, Los Angeles, CA USA
[8] Vitas Hosp, Encino, CA USA
[9] Univ Calif San Diego, San Diego Hlth, San Diego, CA 92103 USA
[10] Univ Calif San Francisco, Med Ctr, San Francisco, CA USA
[11] MedStar Georgetown Univ Hosp, Div Pulm Crit Care & Sleep Med, Washington, DC USA
关键词
OF-LIFE CARE; TEACHING COMMUNICATION-SKILLS; HIGH-RISK; UNIT; ICU; END; PROGNOSIS; FAMILIES; INTERVENTIONS; CONSULTATION;
D O I
10.4037/ajcc2017336
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background Integrating palliative care into intensive care units (ICUs) requires involvement of bedside nurses, who report inadequate education in palliative care. Objective To implement and evaluate a palliative care professional development program for ICU bedside nurses. Methods From May 2013 to January 2015, palliative care advanced practice nurses and nurse educators in 5 academic medical centers completed a 3-day train-the-trainer program followed by 2 years of mentoring to implement the initiative. The program consisted of 8-hour communication workshops for bedside nurses and structured rounds in ICUs, where nurse leaders coached bedside nurses in identifying and addressing palliative care needs. Primary outcomes were nurses' ratings of their palliative care communication skills in surveys, and nurses' identification of palliative care needs during coaching rounds. Results Each center held at least 6 workshops, training 428 bedside nurses. Nurses rated their skill level higher after the workshop for 15 tasks (eg, responding to family distress, ensuring families understand information in family meetings, all P < .01 vs preworkshop). Coaching rounds in each ICU took a mean of 3 hours per month. For 82% of 1110 patients discussed in rounds, bedside nurses identified palliative care needs and created plans to address them. Conclusions Communication skills training workshops increased nurses' ratings of their palliative care communication skills. Coaching rounds supported nurses in identifying and addressing palliative care needs.
引用
收藏
页码:361 / 371
页数:11
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