Palliative care Advanced Practice Nurse role in engaging in serious illness conversations
Abstract
Having advanced care planning conversations with patients and/or their substitute decision maker has been shown to lead to many benefits, including aligning a patient’s priorities and health expectations with his or her wishes. Typically, these conversations have been held with physicians, but have evolved over time to also be incorporated into the roles of other healthcare professionals. Advanced practice nurses who are trained to use a framework or an approach when having such conversations has been shown to have merit. As a result, advanced practice nurses are well positioned to be leaders in facilitating such conversations. In this project, the documentation notes of one advanced practice nurse on an in-patient palliative care team were examined, using the Serious Illness Conversation Guide, to evaluate the Advanced Practice Nurse’s contribution to the process of holding advanced planning conversations with patients.
Full Text:
PDFReferences
Ariadne Labs. (2017). Serious Illness Conversation Guide (2017). https://www.ariadnelabs.org/wp-content/uploads/2017/05/SI-CG-2017-04-21_FINAL.pdf
Baik, D., Russell, D., Jordan, L., Dooley, F., Bowles, K. H., & Masterson Creber, R. M. (2018). Using the Palliative Performance Scale to estimate survival for patients at the end of life: A systematic review of the literature. Journal of Palliative Medicine, 21(11), 1651–1661.
Beddard-Huber, E., Strachan, P., Brown, S., Kennedy, V., Marles, M., Park, S., & Roberts, D. (2021). Supporting interprofessional engagement in serious illness conversations: An adapted resource. Journal of Hospice and Palliative Nursing, 23(1), 38–45. https://doi.org/10.1097/NJH.0000000000000712
Bengtsson, M. (2016). How to plan and perform a qualitative study using content analysis. NursingPlus Open, 2, 8–14. https://doi.org/10.1016/j.npls.2016.01.001
Bernacki, R. E., Block, S. D., & American College of Physicians High Value Care Task Force (2014). Communication about serious illness care goals: A review and synthesis of best practices. JAMA Internal Medicine, 174(12), 1994–2003.
Canadian Nurses Association. (2019). Advanced Nursing Practice: A Pan-Canadian Framework. www.cna-aiic.ca
Cancer Care Ontario. (2009). Palliative Care Collaborative Care Plans CCPS: Condensed Version. www.centralhpcnetwork.ca
Daubman, B.-R., Bernacki, R., Stoltenberg, M., Wilson, E., & Jacobsen, J. (2020). Best practices for teaching clinicians to use a serious illness conversation guide. Palliative Medicine Reports, 1(1), 135–142. https://doi.org/10.1089/pmr.2020.0066
Detering, K. M., Hancock, A. D., Reade, M. C., & Silvester, W. (2010). The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial. BMJ, 340, c1345. https://doi.org/10.1136/bmj.c1345
Fine, R. L. (2004). The imperative for hospital-based palliative care: Patient, institutional, and societal benefits. Proceedings (Baylor University. Medical Center), 17(3), 259–264. https://doi.org/10.1080/08998280.2004.11927978.
Gilissen, J., Pivodic, L., Wendrich-van Dael, A., Cools, W., Vander Stichele, R., Van den Block, L., Deliens, L., & Gastmans, C. (2020). Nurses’ self-efficacy, rather than their knowledge, is associated with their engagement in advance care planning in nursing homes: A survey study. Palliative Medicine, 34(7), 917–924. https://doi.org/10.1177/0269216320916158
Hasdianda, M. A., Gray, T. F., Bello, J. L., Ballaron, B., Egorova, N. A., Berry, D. L., & Ouchi, K. (2021). Nurses’ perceptions of facilitating Advance Care Planning conversations in the emergency department. Palliative Medicine Reports, 2(1), 65–70. https://doi.org/10.1089/PMR.2020.0116
Heyland, D. K., Ilan, R., Jiang, X., You, J. J., & Dodek, P. (2016). The prevalence of medical error related to end-of-life communication in Canadian hospitals: Results of a multicenter observational study. BMJ Quality & Safety, 25(9), 671–679. https://doi.org/ 10.1136/bmjqs-2015-004567
Kates, J. (2017). Advance Care Planning Conversations. Journal for Nurse Practitioners, 13(7), e321–e323. https://doi.org/10.1016/j.nurpra.2017.05.011
Kruser, J. M, Benjamin, B. T., Gordon, E. J., Nichelson, K. N., Wunderink, R. G., Holl, J. L., & Schwarze, M. L. (2019). Patient and family engagement during treatment decisions in an ICU: A discourse analysis of the electronic health record. Critical Care Medicine, 47(6), 784–791. https://doi.org/ 10.1097/CCM.0000000000003711
Lally, K., Rochon, T., Roberts, N., & Adams, K. M. (2016). The “Conversation Nurse” Model: An innovation to increase palliative care capacity. Journal of Hospice and Palliative Nursing, 18(6), 556–563. https://doi.org/10.1097/NJH.0000000000000294
McNiff, K. K., Caligiuri, M. A., Davidson, N. E., Farrar, W., Fisher, R. I., Glimcher, L. H., Hanners, R. B., Hwu, P., Johnson, C. S., Pisters, P. W. T., Thompson, C. B., Reddy, A. S., Jagels, B., Kolosky, J. A., Ross, T., & Bird, K. (2021). Improving goal concordant care among ten leading academic cancer hospitals. The Oncologist, 26(7), 533–536. https://doi.org/10.1002/onco.13850
Ontario Palliative Care Network. (2017). Approaches to goals of care discussions. Ontario Palliative Care Network. https://www.ontariopalliativecarenetwork.ca/sites/open/files/ApproachesToGoalsOFCare.pdf
Paladino, J., Kilpatrick, L., O’Connor, N., Prabhakar, R., Kennedy, A., Neal, B., Kavanagh, J., Sanders, J., Block, S., & Fromme, E. (2020). Training clinicians in serious illness communication using a structured guide: Evaluation of a training program in three health systems. Journal of Palliative Medicine, 23(3), 337–345. https://doi.org/10.1089/jpm.2019.0334
Silveira, M. J., Kim, S. Y., & Langa, K. M. (2010). Advance directives and outcomes of surrogate decision making before death. The New England Journal of Medicine, 362(13), 1211–1218. https://doi.org/10.1056/NEJMsa0907901
Speak Up Canada. Advance Care Planning Resource Library. https://www.advancecareplanning.ca/resource-library
Sirianni, G. & Torabi, S. (2020). Addressing serious illness conversations during COVID-19. Canadian Family Physician, 66, 533–536.
Stilos, K., Huynh, L., & Wynnychuk, L. (2021). The Advance Practice Nurse: A valuable resource to increase timely access to palliative care for those in need. Canadian Oncology Nursing Journal, 31(1), 106–108.
Teno, J. M., & Gozalo, P. L. (2014). Quality and costs of end-of-life care: The need for transparency and accountability. JAMA : the Journal of the American Medical Association, 312(18), 1868–1869. https://doi.org/10.1001/jama.2014.14949
Tulsky, J. A., Arnold, R. M., Alexander, S. C., Olsen, M. K., Jeffreys, A. S., Rodriguez, K. L., Skinner, C. S., Farrell, D., Abernethy, A. P., & Pollak, K. I. (2011). Enhancing communication between oncologists and patients with a computer-based training program: A randomized trial. Annals of Internal Medicine, 155(9), 593–601.
Vital Talk. Address Goals of Care. https://www.vitaltalk.org/topics/reset-goals-of-care
Refbacks
- There are currently no refbacks.