Bold Voices - January 2011 - (Page 11)

AT THE BEDSIDE More Patient, Family Contact Needed in EOL Care A quality-improvement intervention study, which found no improvement in the quality of death and length of stay, says improving end-of-life care in the ICU requires interventions with more direct patient and family contact. “Effect of a Quality-Improvement Intervention on End-of-Life (EOL) Care in the Intensive Care Unit: A Randomized Trial,” published online Sept. 10 by the American Thoracic Society (ATS) in the American Journal of Respiratory and Critical Care Medicine, used surveys and medical-record review to assess outcomes for patients dying in the ICU or within 30 hours of ICU discharge. As part of Tools for Improving Palliative and End-of-Life Care AACN resources on palliative and end-of-life care include a self-assessment and an E-learning course, “Promoting Excellence in Palliative & End-of-Life Care,” which features realistic, interactive scenarios and lets you access course material at your convenience from any computer with broadband Web access. Visit for information about this and other free and paid resources. implementing changes as a package from an external source does not work.” The article adds that Curtis believes “palliative care can be improved in institutions more effectively through an internal commitment to the process and through interventions that are developed and supported at the local level, rather than as a set of changes administered from external sources and delivered to institutions as a package.” w w w. y n h h c a r e e r s . o r g the cluster-randomized trial of 12 hospitals, families completed Quality of Dying and Death (QODD) and satisfaction surveys; nurses completed QODD surveys. “Doctors Training for doctors and and nurses at each institution nurses increased their that received communication skills. the intervention underwent training designed to increase their communication skills with one another and with families, and were instructed to discuss end-of-life options openly, as appropriate, with families. The hospitals that were randomized as controls received the intervention after completion of the study,” notes a related article in ADVANCE for Nurses. Lead study author J. Randall Curtis, physician director of the Harborview/University of Washington End-of-Life Care Research Program, Seattle, and immediate past president of ATS, says, “I do not think that our results indicate a failure of palliative care” but “that the method we used of IMPACT Let your voice be heard. When U.S.News & World Report recently named Yale-New Haven Hospital as one of the nation’s top medical centers, it confirmed something we already knew: our critical care nurses do extraordinary work. As of Fall 2010 we will have seven adult intensive care units that provide specialized care, treatment, and monitoring for our critically ill patients. INTENSIVE CARE UNITS Located on the Connecticut Shore, Yale-New Haven Hospital is a 966-bed tertiary care facility with an international reputation for advanced care and leading-edge research. Boasting a longstanding affiliation with Yale University Schools of Nursing and Medicine, we offer nurses comprehensive benefits and a wide range of practice settings to choose from. To learn more about opportunities for experienced nurses, please call us tollfree (866) 811-7797 or visit us online at: EOE AACN BOLD VOICES JANUARY 2011 11

Table of Contents for the Digital Edition of Bold Voices - January 2011

Front/Digital Edition Viewing Guide
Another Angle
AACN Boards and Contact Information
New HHS-CCSC Awards Recognize HAI Reductions
Zero Tolerance for Preventable Incidents Involves Non-Surgical Specialties
Bold Voice: Chatting with MaryAnn Stump
Facebook Asthma?
EOL Care Rises for Heart Failure Patients on Medicare
More Patient, Family Contact Needed in EOL Care
Chronic Lung Disease of Prematurity Increases Respiratory Risk in Day Care
Childhood Obesity Linked to Viral Infections
Pharmaceutical Safety at Home
DTaP, Tdap: What's in a Name?
In Our Journals
STOP-BANG Helps Identify Surgical Patients at Risk
Fewer Blood Transfusions Can Improve Patient Safety, Reduce Costs
Certification Capsules
Dues, NTI and Certification Fees Will Not Increase
From the President

Bold Voices - January 2011