Fedel Patrice, Joosse Laura L, Jeske Lee
Wheaton Franciscan Healthcare, St. Francis, Milwaukee, WI, USA.
J Clin Nurs. 2014 Jul;23(13-14):2012-21. doi: 10.1111/jocn.12457. Epub 2013 Dec 27.
To examine whether an educational intervention and implementation of a validated prognostication tool can improve inpatient acute care nurses' knowledge of palliative care and their comfort in determining the need for palliative care and requesting a palliative care consult from the attending physician.
Patients with chronic illness report low levels of quality of life. Relief from suffering may be found in services provided by palliative care; however, their services are often underused, in part, due to difficulties in prognostication. The Palliative Performance Scale version 2 is a prognostication tool that can help overcome this barrier.
A pretest/post-test design with nursing education intervention was used on an acute care medical unit within a Midwest tertiary hospital.
Survey questions for both pre- and postintervention assessed nurses' knowledge related to palliative care and examined nurses' comfort in identifying patients appropriate for palliative care and requesting consults. Following the presurvey, education on palliative care and the use of the Palliative Performance Scale version 2 was provided during a regularly scheduled staff meeting. Posteducation mentoring occurred for one month prior to the postsurvey.
Pre- and post-test comparisons showed an overall increase in both comfort and knowledge related to palliative care. There was also a significant improvement in the nurses' comfort in identifying patients appropriate for palliative care.
Findings suggest that nursing education on palliative care and Palliative Performance Scale version 2 can improve their knowledge level and comfort in requesting palliative care consults.
Nurses are in the best position to advocate for the patient and the management of their chronic illness. Educating nurses on the philosophy of palliative care and improving their comfort level in assessing the need for palliative care will overcome barriers to consultation.
探讨一项教育干预措施及实施一种经过验证的预后评估工具是否能提高住院急性护理护士对姑息治疗的认知,以及他们在确定患者是否需要姑息治疗并向主治医生请求姑息治疗会诊时的舒适度。
慢性病患者报告生活质量较低。姑息治疗所提供的服务或许能减轻痛苦;然而,其服务常常未得到充分利用,部分原因是预后评估存在困难。《姑息治疗表现量表》第2版是一种预后评估工具,有助于克服这一障碍。
在中西部一家三级医院的急性护理内科病房采用了带有护理教育干预的前测/后测设计。
干预前后的调查问卷评估了护士与姑息治疗相关的知识,并考察了护士在识别适合接受姑息治疗的患者以及请求会诊方面的舒适度。在预调查之后,在定期召开的员工会议上提供了有关姑息治疗及《姑息治疗表现量表》第2版使用方法的培训。在进行后测前的一个月内进行了培训后指导。
前测与后测的比较显示,护士在姑息治疗方面的舒适度和知识水平总体上均有所提高。护士在识别适合接受姑息治疗的患者方面的舒适度也有显著改善。
研究结果表明,关于姑息治疗及《姑息治疗表现量表》第2版的护理教育能够提高护士的知识水平以及他们在请求姑息治疗会诊时的舒适度。
护士最有条件为患者及其慢性病管理进行倡导。对护士进行姑息治疗理念的教育并提高他们在评估姑息治疗需求方面的舒适度,将克服会诊障碍。