Comfort and Capability with End-of-Life Care: A Quality Improvement Project in a Comprehensive Cancer Center

Background: Many nurses express a lack of comfort and capability caring for patients who are dying. Having little end-of-life (EOL) education, experience, and support can contribute to these sentiments. Nurses less-experienced can be guided by the structure inherent within an order set designed to promote patient comfort. This project aimed to evaluate an electronic order set, including evidence-based medications, and structured symptom assessments, on nurses’ self-perceived capability and comfort with EOL care. An education module accompanied the intervention. Methods: A descriptive design was used to evaluate nurse demographic information and perceptions about EOL care capability and comfort. Data were captured through anonymous surveys. The survey, adapted from A Survey of Registered Nurses’ Professional Capability and Comfort, was sent to nurses two months after order set implementation. An independent two-group t-test was used to compare aggregate survey results of those who did and did not interface with the order set. Intervention: An EOL order set was designed by a multidisciplinary group. Prior to order set implementation, nurses viewed an education module about EOL care and order set use. Results: There was a statistically significant difference in the comfort and capability scores of nurses who interfaced with the EOL order set verses those that did not. For those who viewed the education module but did not use the order set, no improvement in comfort or capability scores were seen. Conclusions: The use of a structured order set providing appropriate medications and focused nursing assessments enhanced nurses comfort and capability with EOL care.

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Work Title Comfort and Capability with End-of-Life Care: A Quality Improvement Project in a Comprehensive Cancer Center
Access
Open Access
Creators
  1. Mary Elizabeth Davis, MSN, RN, CHPN, AOCNS
Keyword
  1. "DNP Project", End-of-Life, Oncology, Comfort, Capability, Order Set
License All rights reserved
Work Type Project
Acknowledgments
  1. Kelly A. Wolgast, DNP, RN, FACHE, FAAN
  2. Lisa Kitko, RN, PhD, FAHA, FAAN
Publication Date 04/25/2020
DOI doi:10.26207/brzz-4462
Deposited April 25, 2020

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