ICU Bedside Nurses' Involvement in Palliative Care Communication: A Multicenter Survey

Wendy G Anderson; Kathleen Puntillo; Deborah Boyle; Susan Barbour; Kathleen Turner; Jenica Cimino; Eric Moore; Janice Noort; John MacMillan; Diana Pearson; Michelle Grywalski; Solomon Liao; Bruce Ferrell; Jeannette Meyer; Edith O'Neil-Page; Julia Cain; Heather Herman; William Mitchell; Steven Pantilat

doi:10.1016/j.jpainsymman.2015.11.003

ICU Bedside Nurses' Involvement in Palliative Care Communication: A Multicenter Survey

J Pain Symptom Manage. 2016 Mar;51(3):589-596.e2. doi: 10.1016/j.jpainsymman.2015.11.003. Epub 2015 Nov 18.

Authors

Wendy G Anderson¹, Kathleen Puntillo², Deborah Boyle³, Susan Barbour⁴, Kathleen Turner⁴, Jenica Cimino⁵, Eric Moore⁶, Janice Noort⁶, John MacMillan⁶, Diana Pearson⁶, Michelle Grywalski³, Solomon Liao³, Bruce Ferrell⁷, Jeannette Meyer⁷, Edith O'Neil-Page⁷, Julia Cain⁸, Heather Herman⁸, William Mitchell⁸, Steven Pantilat⁵

Affiliations

¹ Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA. Electronic address: Wendy.Anderson@ucsf.edu.
² Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, California, USA.
³ University of California, Irvine Health, Orange, California, USA.
⁴ University of California, San Francisco Medical Center, San Francisco, California, USA.
⁵ Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA.
⁶ University of California, Davis Medical Center, Sacramento, California, USA.
⁷ University of California, Los Angeles Medical Center, Los Angeles, California, USA.
⁸ University of California, San Diego Medical Center, San Diego, California, USA.

PMID: 26596882
DOI: 10.1016/j.jpainsymman.2015.11.003

Abstract

Context: Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses.

Objectives: To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication.

Methods: A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via e-mail in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, U.S.

Results: The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%).

Conclusion: ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.

Keywords: Critical care nursing; family; interdisciplinary communication; palliative care.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Communication*
Critical Care Nursing* / methods
Humans
Nurse's Role
Nurses / psychology*
Palliative Care* / methods
Tertiary Care Centers