A one hour teaching intervention can improve end-of-life care

Abstract

Background: It is not known if standard nursing actions are tailored to patient preferences for comfort measures during End of Life (EOL) care.

Objectives: Determine the effect of a brief teaching intervention on student care of EOL patients.

Design: Pre-test/post-test intervention design.

Settings: Two large public universities and one smaller private Catholic institution (all in the United States [U.S.]).

Participants: 471 nursing students attending class as part of their required nursing curriculum.

Methods: A previously developed aggressiveness of nursing care scale was modified to determine students' behavioral intentions for the care of the EOL patient before and after a standardized lecture. The lecture was designed to help students recognize that nursing care priorities for the EOL patient may need to be different than for other patients in order to provide the best quality of remaining life.

Results: Nursing students prior to the lecture had aggressiveness of care scores similar to those of experienced staff nurses, and were more likely to provide more aggressive care to younger patients without DNR orders than to older patients with a DNR order. Following the lecture, aggressiveness of nursing care scores decreased significantly for all EOL patients, and students reported similar behavioral intentions for all EOL patients, regardless of patient age or code status. Student age was marginally related to change in behavior following the lecture. Prior experience in caring for a dying patient or relative did not have a significant effect on aggressiveness of care scores before or after the lecture.

Conclusions: This study demonstrates the effectiveness of a brief teaching intervention to help student nurses take patient preferences and needs into consideration when selecting nursing interventions for the EOL patient.

Keywords: Curriculum; End-of-life; Patient preference; Students.