Palliative Care Professional Development for Critical Care Nurses: A Multicenter Program

Wendy G Anderson; Kathleen Puntillo; Jenica Cimino; Janice Noort; Diana Pearson; Deborah Boyle; Michelle Grywalski; Jeannette Meyer; Edith O'Neil-Page; Julia Cain; Heather Herman; Susan Barbour; Kathleen Turner; Eric Moore; Solomon Liao; Bruce Ferrell; William Mitchell; Kyle Edmonds; Nathan Fairman; Denah Joseph; John MacMillan; Michelle M Milic; Monica Miller; Laura Nakagawa; David L O'Riordan; Christopher Pietras; Kathryn Thornberry; Steven Z Pantilat

doi:10.4037/ajcc2017336

Palliative Care Professional Development for Critical Care Nurses: A Multicenter Program

Am J Crit Care. 2017 Sep;26(5):361-371. doi: 10.4037/ajcc2017336.

Authors

Wendy G Anderson¹, Kathleen Puntillo², Jenica Cimino², Janice Noort², Diana Pearson², Deborah Boyle², Michelle Grywalski², Jeannette Meyer², Edith O'Neil-Page², Julia Cain², Heather Herman², Susan Barbour², Kathleen Turner², Eric Moore², Solomon Liao², Bruce Ferrell², William Mitchell², Kyle Edmonds², Nathan Fairman², Denah Joseph², John MacMillan², Michelle M Milic², Monica Miller², Laura Nakagawa², David L O'Riordan², Christopher Pietras², Kathryn Thornberry², Steven Z Pantilat²

Affiliations

¹ Wendy G. Anderson is an associate professor, Jenica Cimino is a clinical research coordinator, David L. O'Riordan is a senior research specialist, and Steven Z. Pantilat is a professor in the Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California. Anderson is an associate professor and Kathleen Puntillo is a professor emerita in the Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, California. Janice Noort is a palliative care nurse practitioner, Diana Pearson is a critical care nurse educator, Eric Moore is a palliative care and medical surgical nurse manager, Nathan Fairman is a psychiatry and palliative care physician, John MacMillan is a physician and palliative care medical director, Monica Miller is a critical care nurse, and Laura Nakagawa is a social worker at University of California, Davis Medical Center, Sacramento, California. Deborah Boyle is an oncology clinical nurse specialist, Michelle Grywalski is a critical care nurse educator, and Solomon Liao is a palliative care physician and service director at University of California, Irvine Health, Orange, California. Jeannette Meyer and Edith O'Neil-Page are palliative care clinical nurse specialists and Christopher Pietras is director of palliative care at University of California, Los Angeles Medical Center, Los Angeles, California. Pietras is an assistant professor in the Division of General Internal Medicine, Hospitalist Section/Palliative Care, University of California, Los Angeles, California. Bruce Ferrell is a palliative care physician and medical director at Vitas Hospice, Encino, California. Julia Cain and Heather Herman are palliative care nurse practitioners, William Mitchell is a palliative care physician and service director, Kyle Edmonds is a a palliative care physician, and Kathryn Thornberry is a palliative care social worker at University of California, San Diego Health, San Diego, California. Susan Barbour is a palliative care clinical nurse specialist, Kathleen Turner is a critical care bedside nurse, and Denah Joseph is a chaplain and palliative care service associate director at University of California, San Francisco Medical Center, San Francisco, California. Michelle M. Milic is an associate professor in the Division of Pulmonary, Critical Care, and Sleep Medicine, MedStar Georgetown University Hospital, Washington, DC. wendy.anderson@ucsf.edu.
² Wendy G. Anderson is an associate professor, Jenica Cimino is a clinical research coordinator, David L. O'Riordan is a senior research specialist, and Steven Z. Pantilat is a professor in the Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California. Anderson is an associate professor and Kathleen Puntillo is a professor emerita in the Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, California. Janice Noort is a palliative care nurse practitioner, Diana Pearson is a critical care nurse educator, Eric Moore is a palliative care and medical surgical nurse manager, Nathan Fairman is a psychiatry and palliative care physician, John MacMillan is a physician and palliative care medical director, Monica Miller is a critical care nurse, and Laura Nakagawa is a social worker at University of California, Davis Medical Center, Sacramento, California. Deborah Boyle is an oncology clinical nurse specialist, Michelle Grywalski is a critical care nurse educator, and Solomon Liao is a palliative care physician and service director at University of California, Irvine Health, Orange, California. Jeannette Meyer and Edith O'Neil-Page are palliative care clinical nurse specialists and Christopher Pietras is director of palliative care at University of California, Los Angeles Medical Center, Los Angeles, California. Pietras is an assistant professor in the Division of General Internal Medicine, Hospitalist Section/Palliative Care, University of California, Los Angeles, California. Bruce Ferrell is a palliative care physician and medical director at Vitas Hospice, Encino, California. Julia Cain and Heather Herman are palliative care nurse practitioners, William Mitchell is a palliative care physician and service director, Kyle Edmonds is a a palliative care physician, and Kathryn Thornberry is a palliative care social worker at University of California, San Diego Health, San Diego, California. Susan Barbour is a palliative care clinical nurse specialist, Kathleen Turner is a critical care bedside nurse, and Denah Joseph is a chaplain and palliative care service associate director at University of California, San Francisco Medical Center, San Francisco, California. Michelle M. Milic is an associate professor in the Division of Pulmonary, Critical Care, and Sleep Medicine, MedStar Georgetown University Hospital, Washington, DC.

PMID: 28864431
DOI: 10.4037/ajcc2017336

Abstract

Background: Integrating palliative care into intensive care units (ICUs) requires involvement of bedside nurses, who report inadequate education in palliative care.

Objective: To implement and evaluate a palliative care professional development program for ICU bedside nurses.

Methods: From May 2013 to January 2015, palliative care advanced practice nurses and nurse educators in 5 academic medical centers completed a 3-day train-the-trainer program followed by 2 years of mentoring to implement the initiative. The program consisted of 8-hour communication workshops for bedside nurses and structured rounds in ICUs, where nurse leaders coached bedside nurses in identifying and addressing palliative care needs. Primary outcomes were nurses' ratings of their palliative care communication skills in surveys, and nurses' identification of palliative care needs during coaching rounds.

Results: Each center held at least 6 workshops, training 428 bedside nurses. Nurses rated their skill level higher after the workshop for 15 tasks (eg, responding to family distress, ensuring families understand information in family meetings, all P < .01 vs preworkshop). Coaching rounds in each ICU took a mean of 3 hours per month. For 82% of 1110 patients discussed in rounds, bedside nurses identified palliative care needs and created plans to address them.

Conclusions: Communication skills training workshops increased nurses' ratings of their palliative care communication skills. Coaching rounds supported nurses in identifying and addressing palliative care needs.

Publication types

Multicenter Study

MeSH terms

Academic Medical Centers
Critical Care Nursing / education*
Critical Care Nursing / methods*
Education, Nursing, Continuing / methods*
Humans
Nursing Staff, Hospital / education*
Palliative Care / methods*