Nurses' perspectives: hospitalized older patients and end‐of‐life decision‐making

摘要: Aims To explore pressing issues identified by nurses caring for older patients in US NICHE (Nurses Improving Care the Healthsystem Elders) hospitals, regarding palliative care and end-of-life (EOL) decision-making. Objectives are to (1) identify most EOL decision-making strategies address them (2) association of nursing demographics (age, gender, race, education experience), institutional/unit characteristics these issues. Background Critical have an integral role supporting families faced with issues. Despite national imperatives improve quality care, continue experience uncontrolled pain, inadequate communication, disregard their wishes life prolonging interventions. These contribute increased hospitalizations costs. Understanding prevalent is needed patient needs at end-of-life. Design It a mixed method study. Methods A secondary analysis Geriatric Institutional Assessment Profile (GIAP) database (collected 1/08-9/13) was conducted using sample Critical RNs who provided comments Qualitative data were analyzed Dedoose software. Data clusters patterns co-occurring codes explored through iterative process. Themes examined across nurse demographics, institutional unit characteristics. Results Comments specifically addressing 393 critical from 156 hospitals (x‾ age = 42·3 years, 51% BSN degree). Overarching theme discordance goals (prolonging versus life), ineffective physician-patient-family lack time unrealistic expectations. Conclusions Nurses' descriptions highlight need staff availability services. Relevance Practice Palliative will remain priority as people require care.