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O'Conner-Von S, Shlafer R, Galchutt P, Kettering S, Bouterse A, Freese R, Berry P. A Survey of State Correctional Health Care Providers on Advance Care Planning: Opportunity for Collaboration With Corrections. Am J Hosp Palliat Care 2024:10499091241226638. [PMID: 38279955 DOI: 10.1177/10499091241226638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2024] Open
Abstract
Prison populations are rapidly aging. Persons in prison age quicker and suffer more chronic illness and disability than their nonincarcerated peers, posing challenges to caring for prisoners who are chronically ill and dying. The goal of our study was to describe state prisons' practices and policies addressing persons in prison with advanced chronic and life limiting illness through a national web-based survey of state-level prison health care professionals. In particular, we focused on advanced care planning, use of health care directives, decision-making about goals of care, including life sustaining treatments, The response rate was 22% for a sample size 152 completed surveys. The average age of respondent was 52 years; majority were female and Caucasian, and had worked in corrections more than 8 years. Nearly half were registered nurses. Most reported their prison did not have a dedicated end-of-life care program and only 11% offered a peer-care program. However, two-thirds indicated their facility provided the opportunity to designate a health care agent with physicians most likely responsible for facilitating completion of a health care directive. It is evident the care of persons aging and dying in prison is complex and requires further investigation addressing staff and prison population education, ethics guidelines for care, compassionate release, and advance care planning. This study suggests that hospice and palliative care professionals could collaborate with corrections professionals and national organizations to provide innovative education and support to enhance the humane care of this vulnerable population.
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Affiliation(s)
| | - Rebecca Shlafer
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | | | - Ali Bouterse
- University of Minnesota, Social Sciences, Minneapolis, MN, USA
| | - Rebecca Freese
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Patricia Berry
- University of Utah College of Nursing, Salt Lake, UT, USA
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Eull D, Looman W, O'Conner-Von S. Transforming acute pain management in children: A concept analysis to develop a new model of nurse, child and parent partnership. J Clin Nurs 2023. [PMID: 36710385 DOI: 10.1111/jocn.16625] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/09/2022] [Accepted: 12/31/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To identify the core components of acute pain management in children, re-conceptualise the process and update the existing model to inform nursing research and clinical practice. BACKGROUND Acute pain in hospitalised children remains suboptimal, despite extensive nursing research and education. Improvements require a patient-centred approach and a conceptual model which includes the role of parents and partnership. DESIGN Using Rodgers' Evolutionary method, a concept analysis was conducted to define the core components for effective acute pain management in children. METHODS A scoping review of peer-reviewed literature from 1990 through 2020 was conducted using the terms "pain management," "pain control," "pain treatment," "multi modal," and "concept*". Abstracts from 85 articles were initially reviewed with 30 articles retained for analysis. Core concepts were identified, defined and synthesised. The PRISMA 2020 checklist was used. RESULTS A new model was developed from a synthesis of past work which incorporates the role of parents, the complexity of the process and definitions for shared decision-making. Trust, safety, collaborative communication and genuine partnership were identified as the core components for effective pain management in children, with the triadic relationship of nurses, patients and parents in genuine partnership foundational to the nursing process. CONCLUSION The new model for acute pain management in children transforms the nurse's role from gatekeeper to facilitator, shifting the process from nurse driven to patient-centred. The new collaborative model will promote shared decision-making for individualised pain assessments, interventions and evaluations. RELEVANCE TO CLINICAL PRACTICE Establishing the nurse, child, parent partnership as an essential foundation to pain management has the potential to expand pain assessments, optimise treatment selections, advancing clinical practice, patient outcomes and nursing science. No Patient or Public Contributions were included in this paper as this was a concept analysis pulling from past works.
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Affiliation(s)
- Donna Eull
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Wendy Looman
- University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
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Bennett FB, O'Conner-Von S. Continuous Commitment: Long-Term Care RNs' Experience Communicating With Residents and Their Families About End-of-Life Care Preferences. J Gerontol Nurs 2022; 48:29-36. [DOI: 10.3928/00989134-20221003-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hagstrom S, O'Conner-Von S, Tracy MF. Survey of Nurses' Use of the Clinically Aligned Pain Assessment (CAPA) Tool. Pain Manag Nurs 2022; 23:568-575. [PMID: 35551846 DOI: 10.1016/j.pmn.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Limited research is available on tools for assessing pain and its effect on function in the acute care setting. AIM This research's purpose is to describe nurses' use of the Clinically Aligned Pain Assessment (CAPA) tool and their beliefs about its utility for assessing pain compared to the numeric rating scale (NRS) in a hospital where CAPA had been used for 6 years. DESIGN A cross-sectional self-report survey. METHODS Nurses (N = 110) from 13 adult inpatient units in an academic center participated in this survey describing frequency of CAPA and NRS use, CAPA domains documented, and how nurses asked about pain and distinguished between categories when coding for documentation. Beliefs about the tools' effectiveness were also reported. RESULTS Most nurses used CAPA routinely for assessments; almost half used the NRS at times. They believed both tools were effective for assessment, but CAPA was more effective to determine what intervention was needed. They also believed patient report using CAPA was more likely to match the nurse's assessment; a majority reported incorporating their observations into CAPA documentation. Most asked the patient about pain without using CAPA words, although many used the specific words. Practice varied in how nurses determined which category to select in the comfort domain and which domains were assessed routinely. CONCLUSIONS Although many nurses believed CAPA was effective, variation existed in how it was used to assess and document pain, increasing potential for inconsistent assessments and interpretations of pain and pain management.
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Affiliation(s)
| | | | - Mary Fran Tracy
- M Health Fairview, Minneapolis, Minnesota; University of Minnesota School of Nursing, Minneapolis, Minnesota
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O'Conner-Von S, Bennett F. Long-Term Care Nurses and Their Experiences With Patients' and Families' End-of-Life Preferences: A Focus Group Study. J Gerontol Nurs 2021; 46:23-29. [PMID: 33232494 DOI: 10.3928/00989134-20201106-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/08/2020] [Indexed: 11/20/2022]
Abstract
Long-term care (LTC) nurses are a critical nexus for patient communication and vital to advance care planning due to their professional role and breadth of patient relationships. The current study's aim was to explore the communication strategies Midwestern LTC nurses use to clarify patients' end-of-life (EOL) care preferences. Two focus groups used a phenomenological framework to elucidate the experiences of 14 RNs. Data analysis revealed two themes grounded in time: (a) nurses use time to assess patients' EOL situation and assist patients to discern care options; and (b) nurses educate patients about EOL care, adjust care plans, and develop trusting relationships. Two themes were grounded in clinical experience: (a) nurses become persistent advocates and educators to initiate and sustain EOL communication; and (b) nurses learn consistency in communication, including awareness of patients' nonverbal communication. Nurses shared that EOL communication is never "done"; time frames to assess, educate, and clarify are continuous. [Journal of Gerontological Nursing, 46(12), 23-29.].
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O'Conner-Von S, Hagstrom S, Tracy MF. R3. Nurses' Use of the Clinically Aligned Pain Assessment (CAPA) Tool. Pain Manag Nurs 2021. [DOI: 10.1016/j.pmn.2021.02.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bennett F, O'Conner-Von S. Communication Interventions to Improve Goal-Concordant Care of Seriously Ill Patients: An Integrative Review. J Hosp Palliat Nurs 2021; 22:40-48. [PMID: 31764395 DOI: 10.1097/njh.0000000000000606] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Effective communication between clinicians and seriously ill patients and their families about a patient's goals of care is essential to patient-centered, goal-concordant, end-of-life care. Effective goals-of-care communication between clinicians and patients is associated with improved patient and family outcomes, increased clinician satisfaction, and decreased health care costs. Unfortunately, clinicians often face barriers in goals-of-care communication and collaboration, including a lack of education, time constraints, and no standardized protocols. Without clear goals-of-care communication, patients may not be able to provide guidance to clinicians about their end-of-life preferences. The purpose of this integrative review was to examine the efficacy of goals-of-care communication interventions between patients, families, and clinicians in randomized controlled trials published between 2009 and 2018. Twenty-three studies met the inclusion criteria with an overall sample (N = 6376) of patients, family members, and clinicians. Results revealed of the 6 different intervention modes, patient decision aids and patient-clinician communication consistently increased comprehension and communication. Twelve of the studies had nurses facilitate or support the communication intervention. Because nurses are a critical, trusted nexus for communication about end-of-life care, focusing on nurse interventions may significantly improve clinical outcomes and the patient experience.
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Abstract
Faculty perspectives about holistic nursing education (HNE) were investigated in this descriptive study. All nurse faculty teaching in a religious-affiliated university were invited to complete a researcher-developed survey; surveys were analyzed to identify themes related to respondents' definitions of HNE. Themes included teaching holistic nursing, seeing with holistic eyes, and using holistic pedagogy. Respondents' definitions of HNE were found to be consistent with professional standards and competencies. Respondents were nearly unanimous in describing the importance of educating students to see persons holistically, engage in reflection and self-care, and be knowledgeable about holistic nursing and complementary health approaches.
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Affiliation(s)
- Kathleen A Kalb
- About the Authors Kathleen A. Kalb, PhD, RN, is an associate professor, St. Catherine University Department of Nursing, Saint Paul, Minnesota. Susan O'Conner-Von, PhD, RN, is an associate professor, University of Minnesota School of Nursing. The authors gratefully acknowledge the nursing faculty at St. Catherine University who participated in this study. For more information, contact Dr. O'Conner-Von at
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Abstract
Adolescents who struggle with trichotillomania (TTM; hairpulling disorder) are not alone, their parents also struggle. The focus of this qualitative study was to identify what parents (N = 30) perceive as stressful about parenting an adolescent with TTM and how they cope with these stressors. Parents described uncertainty about the course of the disorder and powerlessness in the ability to protect their adolescent from the reactions of others or assist them in curtailing the hairpulling as very distressing. Data analysis revealed eight coping strategies used to manage these stressors and the accompanying grief: (a) information gathering, (b) anticipatory guidance, (c) crying, (d) hypervigilance, (e) gaining emotional support from others, (f) acceptance, (g) goal revision, and (h) guiding rather than protecting their adolescent. The study findings can be used by school nurses to gain a deeper understanding of this disorder and to provide family-centered care in the school setting.
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Affiliation(s)
- Marcia S Stevens
- School of Nursing, College of Allied Health and Nursing, Minnesota State University, Mankato, Mankato, MN, USA
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Kalb KA, O'Conner-Von S. Strategies in education: breaking down silos, building up teams. Health Prog 2012; 93:38-45. [PMID: 22624232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Kathleen A Kalb
- Henrietta Schmoll School of Health, St. Catherine University, Saint Paul, Minn., USA
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Lindeke LL, Anderson SE, Chesney ML, O'Conner-Von S. Family-centered health care/medical home: APN roles in shaping new care models. J Pediatr Health Care 2010; 24:413-6. [PMID: 20971417 DOI: 10.1016/j.pedhc.2010.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 07/30/2010] [Accepted: 07/30/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Linda L Lindeke
- School of Nursing, University of Minnesota, Minneapolis, MN, USA.
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Looman W, Thurmes A, O'Conner-Von S. Quality of Life among Children with Velocardiofacial Syndrome. Cleft Palate Craniofac J 2009. [DOI: 10.1597/09-009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Educating patients is a primary responsibility of all nurses; however, because of time constraints and staff shortages, pediatric oncology nurses are often unable to adequately prepare patients for cancer treatment. Instead, patients frequently rely on the Internet as a source of information about cancer, some of which can be outdated and inaccurate. Adolescents regard the Internet as a valuable source of health information as it is easily accessible, less threatening, and confidential. Considering the need for accurate, readily available information for adolescents with cancer, the purpose of this study was to develop and validate an innovative, interactive Web-based educational program to prepare early and middle adolescents for cancer treatment. Titled "Coping With Cancer," this program was developed by the investigator after conducting in-depth interviews of adolescent cancer survivors and their parents. Based on the transactional model of coping, the program focuses on enhancing the adolescent's knowledge of cancer, cancer treatment, and healthy coping strategies. Coping With Cancer can be an effective resource for pediatric oncology nurses in providing ongoing education for adolescents with cancer.
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Affiliation(s)
- Susan O'Conner-Von
- Center for Children with Special Health Care Needs, School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA.
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O'Conner-Von S. Preparation of Adolescents for Outpatient Surgery: Using an Internet Program. AORN J 2008; 87:374-98. [DOI: 10.1016/j.aorn.2007.07.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 07/19/2007] [Accepted: 07/19/2007] [Indexed: 11/17/2022]
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Kalb KA, O'Conner-Von S. Ethics education in advanced practice nursing: respect for human dignity. Nurs Educ Perspect 2007; 28:196-202. [PMID: 17715804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Ethics education is an essential component of academic programs that prepare nurses for advanced practice; the concept of respect for human dignity is integral to this education. Sixty-three graduate students enrolled in their first course of a nurse practitioner program completed a researcher-developed Ethics Questionnaire that was designed to elicit their baseline ethics-related knowledge, including their understanding of the concept "respect for human dignity". Qualitative analysis of data yielded findings that validate the importance of using the American Nurses Association Code of Ethics for Nurses with Interpretive Statements as an essential foundation for ethics content and as a framework for understanding the meaning of human dignity in advanced practice nursing. Assessment and learning strategies are recommended.
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Affiliation(s)
- Kathleen A Kalb
- Department of Nursing, College of St. Catherine, St. Paul, Minnesota, USA.
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Abstract
The purpose of this integrative research review was to determine the methodological and substantive characteristics of the research pertaining to preparation of children for surgery, examine pertinent research issues, and suggest recommendations for future research and practice. A total of 400 articles were reviewed using inclusion and exclusion criteria. Twenty-two studies, published between 1974 and 1995, met the criteria and, therefore, constituted the study corpus. The total sample comprised 1,263 subjects. Findings indicate that further research is needed to examine the efficacy of preparation strategies, address diverse populations, and include patient and parent involvement in the preparation process.
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