The attitudes of nurses involved in standardized inpatient comfort care: a pilot study

Abstract

This paper explores nurses' perceptions and attitudes utilizing a standard inpatient comfort-care order set in a critical-access hospital in Southwestern Montana. Comfort care is a subset of palliative care and has been defined as 'an essential part of medical care at the end of life. It is care that helps or soothes a person who is dying. The goal is to prevent or relieve suffering as much as possible while respecting the dying person's wishes' (National Institute on Aging, 2012). With past research showing gaps in continuity of care for patients requiring palliative and comfort care, standardizing the care will give each patient nearing the end of their life, and their family, the opportunity for the best care. A pre- and post-trial-implementation qualitative survey was utilized with the nursing staff at this facility in order to identify areas of weakness with comfort care, and how these weaknesses could be addressed. Initial results showed that nurses felt that more education to both providers and nurses and standardizing care would lead to the most benefit for overall patient care. Providers at this facility worked together to build a standing order set utilizing The BEACON project from the Veterans Affairs (VA) department as well as the order set that was already in the electronic medical record system in order to build one order set that would work best for this facility. Providers and nurses were educated on how to use this order set, as well as the standards of care for nursing. Post-implementation nursing surveys showed that nurses were overall more satisfied with the care they were giving to patients near the end of life, and that they felt the order set was successful in setting the standard of care. Nurses also felt that, by receiving more education in the area of comfort care, this opened the lines of communication between staff members, thus improving patient care.