Abstract NS6: Neuroscience Healthcare professionals want Training for End of Life Management in Catastrophic Stroke Patients

Abstract

Background: There is a paucity of literature on EOL management in patients with catastrophic stroke (CS). CS is unique due to the acuity of the injury and the unresponsive state of the patient. In CS, the families are the decision makers and it is imperative to have the communication skills necessary to begin a difficult conversation with families regarding prognosis and treatment planning. We performed a needs assessment to determine how our Neuroscience staff viewed our current EOL management process and areas for potential improvement. Methods: A multidisciplinary team created a survey with 3 main categories: Process of EOL management, Comfort Level with EOL communication, and roles and responsibility for EOL treatment and decision making. We administered the survey to neuroscience faculty, fellows and advance practice providers (APP), residents, nurses, case managers and social workers. Qualtrics Program pooled the responses of the EOL questionnaire for counts and proportions. Results: The survey was distributed to 419 people with 102 respondents (39.6% MDs, 52.5% RNs, 8.0% others). We found that only 48% of our employees felt comfortable beginning a conversation regarding EOL topics; 67% do not feel trained to address EOL topics and the overwhelming majority felt EOL communication should be part of educational training (Figure). Conclusion: We found that our Neuroscience staff does not have formal training in EOL communication, does not feel comfortable initiating EOL conversations and desires more training in EOL management. Future work should prioritize a patient/family centered approach to EOL care and training for healthcare professions so we are better prepared to handle the needs of our families and patients with CS.