Enhancing Comfort and Value In End-Of-Life Care

Project Topic:

Enhancing comfort and value in end-of-life care

Hospital, City and State:

Berkshire Medical Center, Pittsfield, Massachusetts

Unit:

• 4 West Oncology

CSI Participants:

• Brittany Condon, ADN, RN
• Erika Voltoline, BSN, RN, PCCN ( Coach)

Project Goals/Objectives:

1. Increase patient and family satisfaction with patient care within 6 months of our intervention 50%
2. Increase Healthy Work Environment Assessment Tool (HWEAT) True Collaboration score 15% in 12 months

Project Outcomes:

1. Staff received further education about End-of-life care and pursuing Palliative Care certification
2. Increased the HWEAT aggregate score from 4.49 to 4.6
3. Decreased Skilled Communication HWEAT score from 4.40 to 4.38
4. Increased True Collaboration HWEAT score from 4.18 to 4.27
5. Decreased Oldenberg Burnout Survey score from 37.92 to 36.97

Project Overview:

There is a lack of education and comfort in the administration of medications at the end of life, not only in the administration of medications but also in symptom recognition. To promote a peaceful and dignified death, we need to educate the care team on symptom management and recognition.

A pre-survey was handed out to the 4 West Oncology staff with 10 questions, which varied in terms of which aspects of end-of-life care were found to be most challenging and how comfortable the staff was in discussing those topics with patients and families.

End-of-life care booklets were handed out to families to help assist in information education. When a patient is admitted with a CMO code status, a reflex order will populate a social services consult to help ease the families with the end-of-life process. Sympathy cards were sent to loved ones of patients who died on the unit. Staff were educated about prn analgesics and benzodiazepines administration at the end of life.