Nursing Care at the End of Life: Optimizing Care of the Family in the Hospital Setting.

Most Americans prefer their home as a place of death, but most die in the hospital acute care setting. Nurses are the major providers of hospital-based end-of-life care; therefore, it is imperative to identify family preferences for nursing support during the end of life. An initiative was undertaken to create a blueprint for operationalizing research findings that identified family preferences for nursing support during the peri-death experience of a loved one within acute care. Seven components of an acute bereavement support protocol were delineated: developing room signage, assessing family prioritization parameters of support measures, offering advice on saying goodbye, performing an honoring ceremony, creating a memory keepsake, escorting the family out of the hospital, and sending a sympathy card following the loved one's death.