CSI Summary
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Project Topic:
End of life care
Hospital, City and State:
Bayhealth Hospital, Dover, Delaware
Unit:
Cardiovascular Surgical Intensive Care Unit
CSI Participants:
- Abby Crockett, BSN, RN, CCRN
- Laura Dolbin, BSN, RN, CCRN
- Lori Jester Childers, BSN, RN, CCRN
Project Goals/Objectives:
- Initiate a process for nurses to use when providing end-of-life care to patients
- Obtain 100% staff compliance with the process with applicable end-of-life patients
- Increase patient/family satisfaction
- Decrease staff burnout
- Increase Healthy Work Environment Assessment Tool (HWEAT) standard True Collaboration to a moderate healthy score of at least 4.0
Project Outcomes:
- Offered services to 100% of the appropriate patient population
- Spread projected to Sister Unit, 2 North
- Decreased distress felt by staff regarding end-of-life care from 15.3% always and 76.9% sometimes to 0% always and 65% sometimes
- Improved personal satisfaction with current end of life process from 8% never to 0%, 54% sometimes to 10% and 0% always to 42%
- Increased HWEAT True Collaboration score to moderately healthy score of 4.15
- Increased HWEAT aggregate score and all standards scores
Project Overview:
The CSI team noted that there were levels of distress felt amongst the staff in our unit when dealing with end-of-life cases based upon the results of our preclinical data survey. As a team, we each had heavily felt this burnout. We knew that we could never completely alleviate the grief felt by the families after losing a loved one. However, the CSI team created this project to help ease the burden on a family member by giving them a token to remember their family. This project gives nurses someone to help, and that eases our distress as nurses moving forward.
The CSI team introduced the project during our kickoff party in April 2024. At the kickoff party, we provided information about what we would be offering patients’ families in end-of-life situations. We had our kickoff party overlap between day/night shifts so that both shifts could attend. If staff members were unable to attend the party, we had them check in with us the next time they came to work so they could be educated about our project.
Staff completed the Healthy Work Environment Assessment Tool (HWEAT) before initiation of the project on the unit. Our aggregate HWEAT score pre-project implementation was 3.76, which depicts a somewhat healthy work environment. By the end of our project, our aggregate HWEAT score improved to 4.15, indicating a moderately healthy work environment. The feedback about our project has been positive. We have had little to no pushback from staff. The End-of-life resources have been offered to every applicable family. The project's interventions have been incredibly fulfilling for our staff with end-of-life cases. We hope that it will continue to grow within our hospital and that all units will have similar resources to offer.
Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.
Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.