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End-of-life care in postgraduate critical care nursing curricula:
An evaluation of current content informing practice
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End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice

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Ranse K, Delaney L, Ranse J, Coyer F, Yates P. (2018). End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice. Poster presented at the ANZICS/ACCCN Intensive Care Annual Scientific Meeting, Adelaide, 11th - 13th October.

Publié dans : Santé & Médecine
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End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice

  1. 1. End-of-life care in postgraduate critical care nursing curricula: An evaluation of current content informing practice Dr Kristen Ranse1, Ms Lori Delaney2, Dr Jamie Ranse1, Assoc Prof Fiona Coyer2, Prof Patsy Yates2 1. Griffith University, 2. Queensland University of Technology BACKGROUND • The provision of end-of-life care is a significant component of work for critical care nurses. • In a national survey of Australian critical care nurses, only 44% of participants reported that their postgraduate nursing education included end-of-life care content relevant to the critical care context [1]. • The inclusion of end-of-life care content in critical care curricula is needed to address the complexity of this area of practice. OBJECTIVE To identify and describe end-of-life care content in postgraduate critical care nursing courses in Australia. METHODS Participants In August 2015, a search of the internet identified a nursing academic or educator from each of the 17 Australian education providers found to be offering a postgraduate critical care nursing program. Data collection Between November 2015 to August 2016, an individual structured telephone interview was undertaken with each participant. The format of the interview was structured into two parts. Part 1 collected participant demographic information and information pertaining to the individual critical care program characteristics. Part 2 explored the end of life content areas included in the postgraduate critical care nursing program. Data analysis Data obtained was manually entered into a Microsoft Excel spreadsheet for analysis. Data was summarised by calculating median and interquartile range for continuous variables, and frequency and percentage for categorical variables. RESULTS • Participants representing 13 individual education providers completed a telephone interview (response rate 76%) • Critical care programs were offered either fully online (n = 5) or via blended delivery which include online and face to face teaching intensives (n = 8) • Significant variation in student numbers existed with two education providers graduating 5 students and one program graduating 450 students per annum (median 25; IQR 15 – 85). • Almost all participants agreed or strongly agreed (92%) that end of life content was important in postgraduate critical care nursing curriculum, with participants agreeing or strongly agreeing (77%) that more time should be allocated to end of life content. • The majority of programs addressed content related to legal and ethical issues and organ donation. • The content least commonly addressed pertained to the work of the nurse in providing direct clinical care to patients at end of life. RECOMMENDATIONS Education • Targeted educational initiatives need to be implemented that address the care and inclusion of the family and physical care of the patient. Practice • Identification of end of life practice champions amongst clinicians in critical care units, to support critical care nurses engaged in delivery of end of life care. Research • Research to obtain consensus in regard to priority curricula content areas and the associated educational outcomes, informing development of a national approach to end of life in critical care curricula in Australia. Table: End of life content areas in Australian postgraduate critical care nursing curricula (n = 13) CONCLUSION The inclusion of end-of-life care content in critical care curricula is needed to address the complexity of this area of practice. The findings of this study can assist in appropriately targeting the development of resources needed to enhance end-of-life content in critical care curricula, improving preparation of nurses to deliver skilled comprehensive care to patients at the end of life and their families. n % Legal/ethical considerations Legal/ethical issues related to EOL care 10 77 Enduring power of attorney/guardian 6 46 Advanced care directives/plans 6 46 Coronial inquests 5 38 Euthanasia 3 23 Organ donation Determination of death 12 92 Organ donation after brain death 12 92 Communication Communication with family 10 77 Spiritual/cultural support 8 62 Nursing roles in family meetings 7 54 Communication with patient 6 46 Care of self 6 46 Providing emotional support 3 23 Clinical care Use of sedation 7 54 Essential nursing care 6 46 Multidisciplinary roles 6 46 Pharmacology 6 46 Modifying the clinical environment 5 38 Symptom management 5 38 Physical changes at EOL 4 31 Respiratory management 3 23 Care of the body after death 3 23 Withdrawal/withholding treatment 2 15 1. Ranse K, Yates P, Coyer F. Factors influencing the provision of end‐of‐life care in critical care settings: development and testing of a survey instrument. Journal of Advanced Nursing 71 (3), 697-70

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