An End-of-Life Care Educational Series to Improve Staff Knowledge and Comfort Levels

Simulation, Storytelling, and Pediatric End-of-Life Care: A Continuing Professional Development Approach for Nurse Residents

Background: Providing end-of-life (EOL) care to pediatric patients and their families is challenging. Newly licensed nurses, especially those working with the hematology/oncology population, have little to no experience providing the specialized care needed for the dying child. An evidence-based continuing professional development activity provided a novel approach to improve the knowledge, attitudes, and comfort levels of nurse residents related to pediatric EOL care. Method: A high-fidelity simulation module of a pediatric oncology patient at the EOL was embedded into a 12-month nurse residency program. The module employed several teaching strategies including a storytelling approach. Results: Thirteen pediatric nurse residents participated in the program. While the evidence-based intervention increased participants' EOL care knowledge, their overall attitudes, and comfort levels remained unchanged. Discussion: EOL simulation with a storytelling approach is a highly valuable method of teaching new nurses how to care for a dying patient. Additional studies are needed to explore how to increase the comfort levels of new nurses in the delicate population of pediatric hematology/oncology.

The COMFORT Model: Moving the Initiative Outside of the Academy

Reflexive and prospective in nature, the creators of the COMFORT model describe experiences of moving this research outside of the academy. The COMFORT model represents the seven basic principles of healthcare provider communication: C - Connect, O - Options, M - Making Meaning, F - Family Caregivers, O - Openings, R - Relating, T - Team. The COMFORT initiative began as a call for change in healthcare communication education. Originally published as a final chapter in a volume on family and palliative care communication, it was the start of an extensive translational program of trainings and tools addressing healthcare provider communication.

The effectiveness of aesthetic care training on nurses' perceptions of end-of-life care in patients with cancer: a quasi-experimental study

BACKGROUND

Supportive end-of-life care plays a significant role for patients with cancer. Significantly, art and aesthetics in nursing are regarded as key components of nursing practice. They may contribute to supportive end-of-life care that nurses provide for patients with cancer. Therefore, this study aimed to examine the effectiveness of aesthetic care training on nurses' perceptions of end-of-life care in patients with cancer.

METHODS

A quasi-experimental study was conducted with two groups of nurses working in the oncology wards of two hospitals in Kerman, Iran. A sample consisting of 100 nurses was selected by census and randomly assigned to an experimental group (n = 49) and a control group (n = 51). The experimental group received educational workshops on aesthetic care over four weekly-held 90-minute sessions. Both groups completed the Oncology Nurses' Perceptions of End-Of-Life Care (ONPEoLC) Scale before, immediately after, and one month after the intervention. The data were analyzed with SPSS software version 21 using t-test, Chi-square, and repeated measures ANOVA. The significance level was set to p < 0.05.

RESULTS

The mean baseline scores on the ONPEoLC Scale were 163.08 ± 13.58 in the experimental group and 163.27 ± 14.57 in the control group. There was no statistically significant difference between the two groups (P > 0.05). Post-intervention mean scores in the experimental and control groups were 187.1 ± 18.22 and 159.11 ± 22.11, respectively, indicating a statistically significant difference between the two groups (P < 0.001). One month after the intervention, the experimental and control groups' mean scores were 190.89 ± 11.13 and 165.80 ± 11.69, respectively, with a significant difference between the groups (P = 0.001).

CONCLUSION

Based on the results of the present study, designing aesthetic care educational programs is an effective way to improve nurses' understanding of end-of-life care. Therefore, it is recommended that nursing faculties and educational policymakers utilize aesthetic care training to improve the nurses' perceptions of end-of-life care.

Development of an Institution-Wide Pediatric End-of-Life Summit

End-of-life (EOL) care in pediatrics is a unique subspecialty lacking adequate provider education and training. Patient and family outcomes may improve when clinicians are provided with training in this care. Recognizing the need for this specialized education, a small group of bereavement coordinators created an institution-wide pediatric EOL summit at a large urban pediatric teaching hospital. One hundred forty-five clinicians from 14 diverse disciplines attended the first annual pediatric EOL summit. A survey was sent to the participants for feedback. The survey results suggested an overwhelmingly positive response to the summit. Continuing to provide this educational conference is critical to improving care for patients and families, particularly at the end of life.

Factors impacting pediatric registered nurse attitudes toward caring for dying children and their families: A descriptive study

PURPOSE

The purpose of this study was to gain knowledge of the educational preparation and attitudes of registered nurses at a southeastern pediatric hospital toward caring for dying children and their families.

DESIGN AND METHODS

A descriptive study with two independent samples was used to examine the attitudes of registered nurses at a pediatric hospital in southeastern United States. Participants completed the Frommelt Attitude Toward Care of the Dying Scale, Form B, a 30-item survey. Descriptive and inferential statistics were used to analyze data.

RESULTS

One hundred and thirty-two registered nurses participated in the study. Results indicated a statistically significant difference in attitudes toward caring for dying pediatric patient scores in registered nurses working in the hematology/oncology and intensive care units compared to the other units (p = 0.0017; 95% CI: 2.39-10.12).

CONCLUSIONS

This study described the educational preparation and attitudes of registered nurses who care for children who are dying and their families. Additionally, pediatric end-of-life care is complex and is further influenced by experiences and attitudes. Future research is needed to identify educational needs to care for pediatric patients and their families at the end of life.

PRACTICE IMPLICATIONS

Findings from this project indicated end-of-life care education should be integrated into undergraduate curricula. New nurse graduates who are entering the workforce should receive education on end-of-life care, especially if they are entering into a pediatric specific organization. Healthcare organizations should include end-of-life care education as part of the orientation process and annual competency process.

An Evolutionary Concept Analysis of Palliative Care in Oncology Care

This evolutionary concept analysis reports on the concept of palliative care in oncology. Despite its relevance to oncology, the concept of palliative care remains misunderstood, resulting in erroneous interpretations by nurses and health care providers alike. Consequently, integration of palliative care remains heterogeneous and highly contextual. Findings highlight the complexity and ambiguity of the concept of palliative care in the context of oncology care. The nuances and complexity of when to integrate palliative care for patients living with cancer, as well as its evolution from its origins in the hospice movement, have led to its ambiguity in clinical practice.

Testing a Pediatric Palliative Care Education Workplace Intervention

Pediatric palliative care is aimed at pain and symptom management, reducing hospitalization, promoting psychosocial care, and improving quality of life for children with serious illness. As a professional caregiver, nurses play an essential role in the provision of appropriate pediatric palliative care in clinical care settings. The purpose of this quality improvement study was to improve pediatric nurses' awareness and perceptions of palliative care. A 1-group pretest-posttest design was used in the study. A 20-minute education video was used as an intervention to enhance nurses' awareness and perception about pediatric palliative care. Twenty-one pediatric medical-surgical nurses participated in the intervention. Posttest results indicated raised awareness about palliative care, more nurses were able to define palliative care correctly, and nurses were more likely to encourage a palliative care consult. Future studies are needed using larger sample sizes with robust measures to further evaluate the effectiveness of the intervention on enhancing pediatric palliative care awareness among nurses.