J Hosp Palliat Nurs. 2020 Dec;22(6):523-531. doi: 10.1097/NJH.0000000000000704.
Nursing staff play a key role in enhancing a patient's quality of life during end of life; however, they perceive lack of knowledge to be the largest barrier in providing quality end-of-life (EOL) care. Literature suggests that implementation of palliative and EOL care education can improve nursing EOL care practices. In order to address the gap in nursing knowledge and comfort, a quasi-experimental study was conducted; this study included the implementation of a multimodal EOL care educational series on an inpatient pediatric hematology oncology floor over 6 months. Prior to implementation, nursing staff completed a survey to measure perceived knowledge and comfort level regarding EOL care. The series included didactic sessions, in-services, case studies, practice exercises, and interactive discussions led by an interprofessional team of nurses, child-life specialists, and social workers. Educational topics included EOL symptom management, child-life services, supportive care resources, COMFORT communication, and an End-of-Life Nursing Education Consortium course. Following the educational series, the survey was repeated. Results of the survey demonstrated an increase in nursing knowledge and comfort levels. Significant improvements were observed across several items including medication management of dyspnea (χ1,83 =5.1, P = .023), comfort with implementing interventions (χ1,93 = 3.9, P = .049), and knowledge of hospital resources (χ1,93 = 6.1, P = .014). These results suggest that while EOL education strategies can vary, a combination of learner engagement tactics can increase knowledge and comfort regarding EOL concepts and potentially positively impact nursing practice.
护理人员在提高临终患者的生活质量方面发挥着关键作用;然而,他们认为缺乏知识是提供高质量临终关怀的最大障碍。文献表明,实施姑息治疗和临终关怀教育可以改善护理临终关怀实践。为了解决护理知识和舒适度方面的差距,进行了一项准实验研究;这项研究包括在住院儿科血液肿瘤病房实施为期 6 个月的多模式临终关怀教育系列。在实施之前,护理人员完成了一项调查,以衡量他们对临终关怀的知识和舒适度。该系列包括专题讲座、在职培训、案例研究、实践练习和由护士、儿童生活专家和社会工作者组成的跨专业团队进行的互动讨论。教育主题包括临终症状管理、儿童生活服务、支持性护理资源、COMFORT 沟通以及临终护理教育联盟课程。教育系列结束后,再次进行了调查。调查结果显示,护理人员的知识和舒适度水平有所提高。在几个项目中观察到显著改善,包括呼吸困难的药物管理(χ1,83 =5.1,P =.023)、实施干预措施的舒适度(χ1,93 = 3.9,P =.049)以及对医院资源的了解(χ1,93 = 6.1,P =.014)。这些结果表明,虽然临终关怀教育策略可能有所不同,但结合学习者参与策略可以提高对临终关怀概念的知识和舒适度,并可能对护理实践产生积极影响。