Beyond the Final Breath: Nursing Care at the Time of Death (FR457-C)

Abstract

Objectives Explain three benefits to newly bereaved family members of a bathing and honoring practice. Plan implementation of a bathing and honoring practice in the clinical setting. Original Research Background. Approximately one-third of the United States population dies in acute care hospitals. Although nurses are expected to give compassionate care around the time of death, the literature lacks specific evidenced-based interventions for care after death. Research Objectives. We conducted a qualitative study to examine family members’ experience of a bathing and honoring practice as part of nursing care after patient death. Methods. Following a patient death, all families on the oncology unit at Santa Barbara Cottage Hospital were offered the opportunity to participate in bathing their loved one and reciting nondenominational honoring words. This was called the bathing and honoring practice (the practice). Of 149 patients who died, 89 (60%) of the family members chose to participate in the practice. Three months after the patient’s death, we interviewed 13 family members by telephone using a semistructured qualitative interview script. Interviews were recorded, transcribed, and verified. Three investigators analyzed the interviews independently and then collectively using conventional and summative qualitative content analysis methods. We coded emergent themes and grouped them into categories of superordinate themes, ranking them by number of times mentioned and number of interviews in which they occurred. Results. Eleven superordinate themes emerged from the data. The top five themes were (1) positive experience, (2) supported grief process, (3) meaningful experience, (4) honored loved one, and (5) ritually and spiritually significant. Conclusions. A bathing and honoring practice is a beneficial intervention for families after a patient dies in an acute care setting. Implications for Research, Policy, or Practice. This study lends insight into a nursing intervention after patient death that provides a final positive experience for family members and allows them to begin the grieving process. The practice is a ‘‘caring moment, caring occasion’’ as defined by Jean Watson in her Nursing Theory of Caring and meets criteria in domain 7 of the National Consensus Guidelines for Palliative Care. Timing of Survey Administration After Hospice Patient Death: Stability of Bereaved Respondents (FR457-D) Eleanor Dibiasio Brown University, Barrington, RI. Joan Teno, MD MS, Brown University, Providence, RI. Melissa Clark, PhD, Brown University, Providence, RI. Carol Spence, PhD, National Hospice and Palliative Care Organization, Alexandria, VA. David Casarett, MD MA FAAHPM, University of Pennsylvania Health System, Philadelphia, PA.