The Discomfort with Comfort Care Delivery in the Acute Hospital Setting: Is End-of-Life Care Education for Hospital Nurses Necessary? (QI625)

Abstract

•Highlight the number of patients who received end-of-life care in St. Luke's Hospital in Bethlehem from January 2018 to January 2019.•Demonstrate whether nurses are comfortable in providing comfort cares in the acute hospital setting or not.•Assess if comfort care education for the floor nurses is necessary. Death and dying is a complex medical process that affects not just the individual and their loved ones, but the health care providers and the medical system as well. Although the majority of Americans and those with serious illness prefer to die at home, most die in an institutional setting. Hospital nurses, with little experience with end-of-life (EOL) care, then become directly accountable for providing hands-on care and for advocating for appropriate end-of-life care. Thus, familiarity with basic comfort measures is an essential skill for all healthcare providers who are caring for patients whose death is imminent. This study highlights the importance of ensuring that all members of the care team, especially the nurses tasked to deliver these treatments, are well versed in the art of delivering comfort care at the end of life. An observational, retrospective electronic medical record (EMR) review was conducted of adult patients who received end-of-life care at St. Luke's University Hospital in Bethlehem, PA, from January 2018 to January 2019. An electronic survey aimed to determine the comfortability of hospital nurses in delivering EOL care was provided to the floor nurses in the same hospital. Education on EOL care tailored for nurses is needed in the acute hospital setting. Although majority of Americans and those with serious illnesses prefer to die at home, most die in an institutional setting. In the acute hospital setting, the responsibility of ensuring excellent comfort care often falls on the generalists and on specialists in areas other than palliative care, with hospital nurses taking on the responsibilities of providing hands-on comfort measures. Unfortunately, not all inpatients dying in this setting receive the best evidence-based palliative care. Thus, familiarity with the basic comfort measures is an essential skill for all healthcare providers, particularly hospital nurses who may not have hospice experience but are ultimately responsible for delivering comfort medications.