Factors Associated With In-Hospital Death Among ICU Patients Receiving Palliative Care Consultation (S738)

Abstract

Background. The 2010 Institute of Medicine report on the future of nursing recommends nurses practice to the fullest possible extent, which includes participating in important healthcare conversations. However, many nurses feel ill-prepared to participate in end of life (EOL) conversations due to inadequate training or experience. Research Objectives. To address this problem, project Objectives included: empowering nurse participation in EOL education, building confidence in ability to participate in EOL conversations, and exploring moral distress related to EOL transition. Method. To achieve these Objectives, an interdisciplinary educational forum was piloted using case analysis and panel discussion to engage the audience. Panelists included a physician from palliative care services, an oncology nurse-educator, and a nurse-educator with a specialty in medical ethics. Pre-event survey instruments to measure nurse confidence and frequency of participation in EOL discussions were distributed and collected 1 month preceding the forum. Post-event surveys were distributed and collected 1 month later. Permission was granted to publically share comments. Result. Sixty healthcare professionals attended the educational forum; 24 were nurses from inpatient and outpatient settings at one institution. Eighteen nurses submitted both preand postevent surveys; a 75% response rate. Paired comparisons of preand post-event surveys indicate a modest increase in nurse participation in interdisciplinary family meetings by self-report (pre-post difference, p < 0.05) and a positive trend indicating improved nurse confidence in ability to continue these conversations. Comments indicate a desire and need for similar team-focused discussions to encourage candid dialogue among all interdisciplinary healthcare providers involved in the EOL care transition. Conclusion. This pilot educational forum on EOL discussions laid a positive foundation for future educational projects. Implications for Research, Policy, or Practice. Preparing nurses to participate in EOL discussions with interdisciplinary colleagues provides empowerment to practice and participate in these conversations. Ongoing professional education related to EOL discussions is necessary to improve the quality of patientand family-centered care. Factors Associated With In-Hospital Death Among ICU Patients Receiving Palliative Care Consultation (S738) Ayano Kiyota, MD, University of Hawaii JABSOM, Honolulu, HI. Christina Bell University of Hawaii JABSOM, Honolulu, HI. Kamal Masaki, MD, University of Hawaii, Honolulu, HI. Daniel Fischberg, MD PhD, University of Hawaii JABSOM, Honolulu, HI. (All authors listed above had no relevant financial relationships to disclose.)