Instrument Development: Knowledge, Attitudes, and Confidence in Palliative Care Concepts Held by Trauma and Neuroscience Intensive Care Nurses

2021 ◽  
pp. JNM-D-19-00069
Author(s):  
Carol Diane Diane Epstein ◽  
Christina Ventura-DiPersia

Background and PurposeUnique pressures impact trauma intensive care unit (TICU) nurses in their provision of care for severely injured patients. When it becomes clinically obvious that these patients may not survive, TICU nurses must continue life-saving measures while at the same time consider a palliative care consultation. In order to facilitate this referral, TICU nurses need to have the appropriate knowledge, attitude, and confidence in doing so. The purpose of this study is to refine an instrument that aims to support this process.MethodsA convenience sample of 42 respondents completed the Knowledge, Attitudinal, and Experiential Survey on Advance Directive (KAESAD).ResultsDomains with the highest Cronbach’s alpha value were “professional attitudes” (α = .995) and “clinical experiences” (α = .999).ConclusionsReliability assessments suggest that most domains of the instrument have strong internal consistency, and with a larger sample size, future studies may elucidate how nurse educators can use this instrument to target areas for continuing education.

2020 ◽  
Vol 40 (3) ◽  
pp. 23-29
Author(s):  
Kim Martz ◽  
Jenny Alderden ◽  
Rick Bassett ◽  
Dawn Swick

Background Access to specialty palliative care delivery in the intensive care unit is inconsistent across institutions. The intensive care unit at the study institution uses a screening tool to identify patients likely to benefit from specialty palliative care, yet little is known about outcomes associated with the use of screening tools. Objective To identify outcomes associated with specialty palliative care referral among patients with critical illness. Methods Records of 112 patients with positive results on palliative care screening were retrospectively reviewed to compare outcomes between patients who received a specialty palliative care consult and those who did not. Primary outcome measures were length of stay, discharge disposition, and escalation of care. Results Sixty-five patients (58%) did not receive a palliative care consult. No significant differences were found in length of hospital or intensive care unit stay. Most patients who experienced mechanical ventilation did not receive a palliative care consultation (χ2 = 5.14, P = .02). Patients who were discharged to home were also less likely to receive a consult (χ2 = 4.1, P = .04), whereas patients who were discharged to hospice were more likely to receive a consult (χ2 = 19.39, P < .001). Conclusions Unmet needs exist for specialty palliative care. Understanding the methods of identifying patients for specialty palliative care and providing them with such care is critically important. Future research is needed to elucidate the factors providers use in their decisions to order or defer specialty palliative care consultation.


2019 ◽  
Vol 22 (5) ◽  
pp. 474-475 ◽  
Author(s):  
Ivy Benjenk ◽  
Christina Prather ◽  
Erica Schockett ◽  
Babak Sarani ◽  
Jordan M. Estroff

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