Improving Nursing Provision of Patient Care in High Acuity Medical Units and Fostering Their Wellbeing by Providing Education on End-of-Life Care and Finding Joy and Meaning in Work: A Quality Improvement Project
Doctor of Nursing Practice (DNP)
Doctor of Nursing Practice (DNP) Program
School of Nursing
Mary C. Loughran
Serious illness, Primary Palliative Care, Nursing Ethics, Moral Distress, Palliative Care Nursing Education, End-of-Life Care, Palliative Communication
Palliative care employs a multidisciplinary approach focusing on the quality of life for patients and their families experiencing the complexity of serious illness (Nelson, 2021). Due to shortages of palliative care specialists and a lack of nurse proficiency in caring for people with serious illnesses, integrating a palliative care approach is an ethical obligation for nursing (Parekh de Campos, 2022). Gaps in palliative care and end-of-life education for new nurses coming to the acute care setting in a large tertiary hospital in Southwestern Pennsylvania were identified.
Evidence-based education was delivered by advanced practice providers trained in this content area. Forty-seven nurses received evidence-based Palliative Care Education, integrating a hybrid model utilizing the End-of-Life-Nursing Education Consortium (ELNEC), organization-specific guidelines, and the Clinical Ethics Residency for Nurses curriculum (Grace, 2022). Nurses were asked to complete pre- and post-knowledge assessments, demonstrating increased confidence in all areas. Qualitative data identified areas of moral distress for nursing. Segmented education for nurses that synergizes an interpersonal-interdisciplinary team approach that integrates wellness and mindfulness techniques for emotional processing of challenging patient care scenarios increases nurse confidence and demonstrates a significant increase for Specialty Palliative Care consults. The results also indicated a need to provide further support in areas of nursing ethics, communication tools, and support for nurse agency and well-being.
Keywords: end-of-life care, palliative nursing, existential distress, symptom management, dying in the acute care setting, nursing education for end-of-life or serious illness, nursing theory for end-of-life, nursing ethics, and communication in end-of-life care.
Durant, Donna, "Improving Nursing Provision of Patient Care in High Acuity Medical Units and Fostering Their Wellbeing by Providing Education on End-of-Life Care and Finding Joy and Meaning in Work: A Quality Improvement Project" (2023). Doctor of Nursing Practice (DNP) Manuscripts. 39.