Bold Voices - April 2014 - (Page 17)

AT THE BEDSIDE Palliative Care: Conversations Matter New NINR program helps providers start the right conversation with patients and families. The sheets have answers to common questions about palliative care and are designed to generate discussion among providers, patients and families. For more information, visit the campaign Web pages at AACN Resources for Palliative Care * Palliative and End-of-Life Care - Resources available at * "Bringing Palliative Care to the Surgical Intensive Care Unit" - Critical Care Nurse, February 2013 * "Promoting Excellence in Palliative and End-of-Life Care" - A 3.5-hour course based on AACN Protocols for Practice and other evidence-based resources available at Improving Communication About Chronic Critical Illness B etter communication is required between clinicians and the families of patients with chronic critical illness who are discharged from acute care, advises an article in The New England Journal of Medicine. "Chronic Critical Illness" notes that families of patients who require ventilation are not adequately prepared for the true nature of the prognosis. "Less than half of patients with an ICU admission lasting longer than 2 weeks - or their surrogates - had discussed their prognosis with a physician," the article states. As many of these patients are discharged to a long-term acute care (LTAC) facility, patients and families may believe patients are on the road to recovery and will soon return to their previous standard of living. "These expectations are worlds away from reality," the article adds. Part of the problem is that these chronic illnesses may be caused by the decision in ICU settings to save the patients' lives. Research is ongoing to improve prognostication, including a scoring system in acute care that would note the patients at highest risk for death. Another way to encourage clinicians to have these discussions with patients and families may be to include a rotation to LTAC hospitals, coupled with ICU rotations. This would provide the real-life experience with post-acute hospital care that many patients require. The article concludes that integrating communication and follow-up into training would help clinicians speak with patients and families, giving them the necessary information to make well-informed decisions about care. Families of patients who become chronically critically ill don't understand the true prognosis. 17 AACN BOLD VOICES APRIL 2014 R esearch has shown that palliative care is proven to work along with other treatments to enhance quality of life for children with serious illness, but it can be difficult to discuss in a pediatric setting. Many healthcare providers are reluctant to recommend palliative care for their youngest patients, and parents are often unaware of the benefits. In response, the National Institute of Nursing Research - part of the National Institutes of Health - developed the Palliative Care: Conversations Matter campaign. The pilot program tested materials from the campaign in two healthcare systems to gather feedback from parents, palliative care clinicians and scientists who offered opinions about making communication and care easier. Palliative Care: Conversations Matter resources are designed to help providers initiate these discussions with patients and families. Resources include video vignettes, with advice for providers, and customizable tear-off pads of patient education sheets in both English and Spanish.

Table of Contents for the Digital Edition of Bold Voices - April 2014

Another Angle
President’s Note (Teaser)
NTI2014: You Have to Come! An Unmatched Experience in the Mile High City
AACN Clinical Priorities 2014: Clinical Topics for Bedside Clinicians
NTI Network: Connect Online to Plan Your Week
Step Forward! Vote in AACN’s Election 2014
You May Inherit Atherosclerosis From Your Mummy
Pain, Agitation, Delirium Guidelines Expand Nurses’ Toolkit
Pediatric Flu Deaths Still a Concern, Expanded Vaccinations Advised
Are Senior-Specific EDs Worth the Investment?
‘Stop Sepsis’ Program Reduces Mortality Rate 40 Percent
Better Relationships Between Nurses, Cleaning Staff Can Improve Patient Care
Patient Outcomes Improve With Surgeon-Led Mortality Reviews
Reducing Cross-Contamination from Healthcare Personnel Attire
New Biomarker Could Improve Outlook in Esophageal Cancer
Long-Term Survival of Kids After Out-of-Hospital Cardiac Arrest
Tight Glycemic Control Could Shorten Children’s Hospital Stay
Web-based Patient Portals Improve Self-Management
In Our Journals
Nurse-Patient Communication Enhanced in AACN CSI Academy Projects
Link Between Shingles and Stroke Risk?
In Utero Exposure to Dyslipidemia Heightens High LDL Risk in Offspring
Palliative Care: Conversations Matter
Improving Communication About Chronic Critical Illness
Certification Capsules
April 16: National Healthcare Decisions Day
New Editorial Consults, Other Publishing Events at NTI 2014
AACN Scholarships for August EBP, Research Methods Institutes
Early-Bird Registration Ends April 3
Attend the Chapter Leadership Development Workshop at NTI 2014
Vote Now!
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - April 2014