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Improving Palliative Care Conversations Through Targeted Education and Mentorship
Lorraine Burgunder-Zdravkovski1, Yuri Guzman, Constance Creech
1Lorraine Burgunder-Zdravkovski, DNP, RN, FNP-BC, NP-C, is a provider at Najem Pediatrics and ADHD Clinic and is adjunct nursing faculty at Madonna University, Livonia, Michigan. Yuri Guzman, DNP, RN, is a practitioner at Michigan Medicine University Hospital, Ann Arbor. Constance Creech, EdD, MSN, RN, ANP-BC, is Director of Graduate Nursing Programs and Professor of Nursing, University of Michigan-Flint. Deborah Price, DNP, MS, RN, is clinical assistant professor, University of Michigan-Ann Arbor. Marilyn Filter, PhD, CNM, MS, RN, is associate professor of nursing, University of Michigan-Flint.
Abstract:
Health care provider communication proficiency is critical in the initiation and revisitation of these discussions throughout the trajectory of chronic illness. The delivery of palliative care (PC) throughout the continuum of illness has traditionally been underutilized. Nurses have the ability to significantly improve PC utilization through the use of advance care planning strategies to confidently initiate conversations with patients and families at multiple points throughout the continuum of illness. Nurses are uniquely positioned to contribute to the improvement of care provided to terminally and chronically ill patients because of the relationship developed and the knowledge of patient-specific disease progression that unfolds during the time spent with patients. In this study, nurses improved communication efficacy by learning to utilize advance care planning-specific interview strategies inclusive of scripting and cued language when initiating PC conversations. The preintervention/postintervention confidence levels of nurses in initiating early PC conversations significantly increased to improve the delivery of PC to patients.
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