Date Available

5-2-2025

Year of Publication

2025

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Elizabeth Tovar

Committee Member

Dr. Ashley Montgomery-Yates

Faculty

Dr. Julianne Ossege

Abstract

Background: This study addresses the gap in education and training for medical intensive care unit (MICU) nurses regarding the care of hospice patients. The traditional medical model of healthcare prioritizes illness treatment, often leading to inadequate end-of-life support and increased hospitalization during patients' final days. The rise of in-hospital hospice programs, or scatter-bed hospice models, highlights the need for nurses to enhance their skills in providing end-of-life compassionate care. The MICU at the University of Kentucky’s Chandler Hospital serves as a focal point for this initiative, given its role in caring for critically ill patients who require hospice attention.

Purpose: This project aimed to evaluate and enhance the knowledge and comfort levels of MICU nurses at UK Chandler Hospital in providing proper care for hospice patients through a targeted educational program. Focused on key areas such as pain management, symptom control, and compassionate care, the initiative utilized the End-of-life Nursing Education Consortium critical care curriculum to improve nurse competency and confidence. By addressing the unique needs of hospice patients, the project sought to bridge the knowledge gap and ultimately improve care outcomes for patients during critical end-of-life moments.

Methods: By implementing targeted training and providing a practical resource (hospice care pocket cards), the initiative aimed to transform end-of-life care practices within the MICU. This study utilized a quasi-experimental one-group time series design to evaluate the impact of nursing education interventions, including the use of hospice care pocket cards, on the care of terminally ill patients in the MICU at UK Chandler Hospital. By assessing outcomes at two distinct time points, the research aimed to measure improvements in documentation, patient care practices, and nurses' knowledge and comfort with hospice care. The project highlighted the importance of stakeholder engagement and tailored education in fostering effective implementation of hospice principles within a critical care environment.

Results: Although the results showed slight increases in knowledge among nurses, none reached statistical significance. There was a slight decrease in nurses' comfort levels related to hospice care topics. A review of patient data post-intervention demonstrated some improvements in oral care compliance and body positioning, suggesting clinical significance despite the lack of statistically significant findings. Ninety percent of the nurses surveyed expressed that they gained new insight from the educational material and hospice care pocket cards.

Discussion: This study highlights a persistent knowledge gap in hospice care despite existing practices. While educational interventions demonstrated a positive impact on nurses' awareness of hospice topics, statistical significance was not achieved, suggesting a need for further exploration into knowledge retention and application in clinical practice. The findings underscore the necessity for tailored educational programs to improve competencies in hospice care. Ultimately, educating the nurses fosters a more compassionate environment in the MICU for hospice patients.

Conclusion: This study emphasizes the importance of end-of-life care in the MICU, highlighting the current knowledge gaps among nurses regarding hospice care. By implementing an evidence-based educational program, the study aimed to enhance nurses' knowledge, attitudes, and clinical practices, ultimately improving patient-centered care during vulnerable moments. The findings indicate promising trends in care practices, underscoring the need for ongoing education and interdisciplinary collaboration to foster a compassionate environment for patients and nurses.

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