Hasdianda Mohammad Adrian, Gray Tamryn F, Bello Josephine Lo, Ballaron Brittany, Egorova Natasha A, Berry Donna L, Ouchi Kei
Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Palliat Med Rep. 2021 Mar 12;2(1):65-70. doi: 10.1089/pmr.2020.0116. eCollection 2021.
Nurses are well positioned to initiate advance care planning (ACP) conversations because of their unique strength in communication and central patient-facing role in the interdisciplinary team. Nurse-led ACP conversations have demonstrated promising results in settings outside of the emergency department (ED). Understanding ED nurses' perspectives regarding ACP conversations is needed before implementing similar practices in the ED. To explore ED nurses' perception of facilitating ACP conversations. We conducted a cross-sectional survey to assess ED nurses' perceptions of facilitating ACP conversations in the ED. ED nurses at one academic hospital and one community hospital located within the northeastern region of the United States. Seventy-seven (53.1%) out of 145 eligible ED nurses completed the survey. All participants perceived ACP conversations in the ED as at least somewhat important. Forty (51.9%) felt somewhat comfortable in facilitating these conversations. The majority of participants (77.9%) agreed that a specially trained nurse consultation model might be helpful in the ED. We found a correlation between total clinical experience and interest in facilitating ACP conversations in the ED ( = 0.045). ED nurses are well positioned to help patients clarify their goals-of-care and end-of-life care preferences. They perceived ACP conversations to be important and felt comfortable to facilitate them in the ED. Additional studies are needed to empirically test its implementation.
护士在发起预先护理计划(ACP)对话方面具有优势,因为他们在沟通方面具有独特的优势,并且在跨学科团队中处于面向患者的核心角色。由护士主导的ACP对话在急诊科(ED)以外的环境中已显示出有希望的结果。在急诊科实施类似做法之前,需要了解急诊护士对ACP对话的看法。为了探索急诊护士对促进ACP对话的看法。我们进行了一项横断面调查,以评估急诊护士对在急诊科促进ACP对话的看法。美国东北部地区一家学术医院和一家社区医院的急诊护士参与了调查。145名符合条件的急诊护士中有77名(53.1%)完成了调查。所有参与者都认为急诊科的ACP对话至少有些重要。40名(51.9%)护士在促进这些对话时感到有些自在。大多数参与者(77.9%)同意,经过专门培训的护士咨询模式在急诊科可能会有所帮助。我们发现总临床经验与在急诊科促进ACP对话的兴趣之间存在相关性(=0.045)。急诊护士有能力帮助患者明确其护理目标和临终护理偏好。他们认为ACP对话很重要,并对在急诊科促进这些对话感到自在。需要进一步的研究来实证检验其实施情况。