Intervention tool for general registered nurses providing palliative care in the cardiovascular ward

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by JST SPRING. Background Palliative care for patients with heart failure (HF) has benefits such as reducing physical and mental distress and decreasing medical costs. Nevertheless, the palliative care provision rate for patients with HF is merely 0.7%–4%. Palliative care by healthcare professionals in cardiology is recommended for patients with HF, particularly in inpatient wards. To promote palliative care, general registered nurses (GRNs) should be encouraged to practice it, although 99% of them do not have professional qualifications in this field. However, there is no intervention tool for GRNs that provides specific guidelines on palliative care. Therefore, appropriate intervention tools for GRNs are needed to promote palliative care. This study reports a nursing practice model and intervention tool developed before an intervention study in which GRNs practiced palliative care in a cardiovascular ward. Purpose To develop a practice model and intervention tool for GRNs providing palliative care to patients with HF in the cardiovascular ward. Methods This study reports the development of nursing practice models and intervention tools using a comprehensive development approach for nursing intervention development as the methodology and Corbin's (1998) disease trajectory model as the theoretical basis. We conducted a literature review on the needs of and limitations to HF palliative care. We staged the timing of hospitalized patients with HF. A nursing practice model showing suitable nursing support for each stage was constructed. We then created an intervention tool based on the nursing practice model. Results The intervention tools included a pocketbook, an HF palliative care practice material that could be used as a checklist, and an information-sharing notebook that allowed patients to review and record their symptom screening results and end-of-life decisions. The uniqueness of the intervention tool was that it classified hospitalized patients with HF into three stages: symptom-focused stage, cognitive recovery stage, and behavioral recovery stage; each stage included seven nursing support practices. In addition, the intervention tool clarified the criteria for referral to specialized palliative care that could be used before the end-of-life stage and described specific measures for end-of-life decision support that general nurses could implement. Conclusion This study created a pocketbook, an HF palliative care practice material, and a patient notebook as intervention tools. We started the intervention studies in December 2021, and we will report the results later.