Year of Publication

2022

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Debra C. Hampton

Clinical Mentor

Dr. Jessica McFarlin

Committee Member

Dr. Karen Stefaniak

Abstract

Background: Critical care providers in the ICU setting are discovering that their patients are living longer with more comorbid conditions. They are confronted with palliative care situations almost daily. Recently palliative care has been thrust into the forefront of critical care and is a resource critical care nurse practitioners and physicians’ assistants need to be able to utilize. A gap in the literature has been found in the overall education of critical care providers regarding palliative care.

Purpose: The purpose of this study was to determine what palliative care training trauma/cardiac/neurological, and pulmonary critical care providers had previously received prior to practice and licensure, provide an online learning experience for them to participate in to expand their knowledge of palliative care, and to learn about their desire for more training.

Methodology: The study employed a quasi-experimental cohort design involving advanced practice providers who practice at the University of Kentucky in pulmonary, cardiac, neurological or trauma critical care. The study procedures consisted of a pre-educational intervention survey, an educational intervention, and a post educational intervention survey. The educational intervention involved a short module on palliative care basics involving communication and symptom management.

Results: Of the participants, 88% indicated they would like additional palliative care training. Seventy-two percent indicated they had never received palliative care training prior to independent practice. The provider was found to the be the largest facilitator of palliative care consults. Family was found to be the largest barrier to palliative care involvement. End of life/goals of care discussion was found to be the biggest challenge for the participants.

Discussion: Further research is needed on the most efficient training modality for palliative care in critical care providers. This study suggests that a starting point for training would be the online educational modules through the Center to Advance Palliative Care (CAPC) program. More education may be needed for family members of critically ill patients via community health and primary care physicians prior to intensive care unit admission to prevent being barriers to palliative care.

Conclusion: The majority of advanced practice providers did not receive formal palliative care training prior to their graduation or onboarding at their institutions where they are currently employed. Providers indicated they would participate in more training if offered by their institution. The significance of the family being found as the largest barrier to palliative care warrants more research to discover the best course of action to decrease this incidence. Additionally, more studies are needed to determine the best plan for palliative care training for critical care providers.

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