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An interdisciplinary workshop to improve palliative care: Advanced heart failure— Clinical guidelines and healing words

Published online by Cambridge University Press:  29 June 2006

JANE G. ZAPKA ,
WINNIE HENNESSY ,
YAN LIN ,
LISA JOHNSON ,
DIANE KENNEDY  and
SARAH J. GOODLIN
JANE G. ZAPKA
Affiliation:
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina
WINNIE HENNESSY
Affiliation:
MUSC Palliative Care, Charleston, South Carolina
YAN LIN
Affiliation:
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina
LISA JOHNSON
Affiliation:
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, South Carolina
DIANE KENNEDY
Affiliation:
Lowcountry AHEC, Varnville, South Carolina
SARAH J. GOODLIN
Affiliation:
Patient-centered Education and Research, Salt Lake City, Utah
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Abstract

Objective: Effective communication is recognized as an essential process to providing quality care, including palliative and end-of-life care. Discussion of prognosis and support needs of patients with heart failure is particularly challenging given the nature of the condition and care across several settings. The objective was to design, implement, and evaluate an interdisciplinary workshop aimed at improving attitudes and skills related to communication with patients and family, health team communication and documentation, and assessment of physical and emotional symptoms.

Methods: A pretest, delayed posttest evaluation design was used to evaluate two 4-h workshops offered to nurses, social workers, and other nonphysician clinicians.

Results: Although baseline reports of skills were high for the participants, significant improvement was noted for objectives emphasized in the workshop.

Significance of results: This project demonstrated the feasibility of designing, marketing a brief workshop, and positively impacting communication and documentation skills.

Keywords

InterdisciplinaryContinuing educationPalliative careHeart failure
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 1 , March 2006 , pp. 37 - 46
Copyright
© 2006 Cambridge University Press

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References

REFERENCES

Albert, N.M., Davis, M., & Young, J. (2002). Improving the care of patients dying of heart failure. Cleveland Clinic Journal of Medicine, 69, 321–328.Google Scholar
American Heart Association (2005). Heart Disease and Stroke Statistics—2005 Update. Dallas: Author.
Back, A.L., Arnold, R.M., & Quill, T.E. (2003a). Hope for the best, and prepare for the worst. Annals of Internal Medicine, 138, 439–444.Google Scholar
Back, A.L., Arnold, R.M., Tulsky, J.A., et al. (2003b). Teaching communication skills to medical oncology fellows. Journal of Clinical Oncology, 21, 2433–2436.Google Scholar
Block, S.D. & Billings, J.A. (2001). The Program in Palliative Care Education and Practice. Cambridge, MA: Harvard Medical School Department of Continuing Education.
Block, S.D. & Sullivan, A.M. (1998). Attitudes about end-of-life care: A national cross-sectional study. Journal of Palliative Medicine, 1, 347–355.Google Scholar
Booth, K., Maguire, P.M., Butterworth, T., et al. (1996). Perceived professional support and the use of blocking behaviours by hospice nurses. Journal of Advanced Nursing, 24, 522–527.Google Scholar
Clarke, E.B., Curtis, J.R., Luce, J.M., et al. (2003). Quality indicators for end-of-life care in the intensive care unit. Critical Care Medicine, 31, 2255–2262.Google Scholar
Curtis, J.R., Patrick, D.L., Shannon, S.E., et al. (2001). The family conference as a focus to improve communication about end-of-life care in the intensive care unit: Opportunities for improvement. Critical Care Medicine, 29, N26–33.Google Scholar
Fineberg, I.C. (2005). Preparing professionals for family conferences in palliative care: Evaluation results of an interdisciplinary approach. Journal of Palliative Medicine, 8, 857–866.Google Scholar
Gibbs, J.S., McCoy, A.S., Gibbs, L.M., et al. (2002). Living with and dying from heart failure: The role of palliative care. Heart, 88(Suppl 2), ii36–39.Google Scholar
Gillick, M.R. (2005). Rethinking the central dogma of palliative care. Journal of Palliative Medicine, 8, 909–913.Google Scholar
Goodlin, S.J., Hauptman, P.J., Arnold, R., et al. (2004). Consensus statement: Palliative and supportive care in advanced heart failure. Journal of Cardiac Failure, 10, 200–209.Google Scholar
Griffin, J.P., Nelson, J.E., Koch, K.A., et al. (2003). End-of-life care in patients with lung cancer. Chest, 123, 312S–331S.Google Scholar
Hauptman, P.J. & Havranek, E.P. (2005). Integrating palliative care into heart failure care. Archives of Internal Medicine, 165, 374–378.Google Scholar
Hogan, C., Lunney, J., Gabel, J., et al. (2001). Medicare beneficiaries' costs of care in the last year of life. Health Affairs, 20, 188–195.Google Scholar
Hunt, S.A., Abraham, W.T., Chin, M.H., et al. (2005). ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). American College of Cardiology Web Site. Available at: http://www.acc.org/clinical/guidelines/failure//index.pdf.
Institute of Medicine (1997). Approaching Death: Improving care at the end of life. Washington, DC: National Academy Press.
Lipson, A.R., Hausman, A.J., Higgins, P.A., et al. (2004). Knowledge, attitudes, and predictors of advance directive discussions of registered nurses. Western Journal of Nursing Research, 26, 784–796.Google Scholar
Lunney, J.R., Lynn, J., Foley, D.J., et al. (2003). Patterns of functional decline at the end of life. Journal of the American Medical Association, 289, 2387–2392.Google Scholar
Morrison, R.S. & Meier, D.E. (2004). Clinical practice. Palliative care. New England Journal of Medicine, 350, 2582–2590.Google Scholar
National Association of Social Workers (2004). NASW Standards for Social Work Practice in Palliative and End of Life Care. NASW Press, Annapolis Junction, Maryland 20701.
Pantilat, S.Z. & Steimle, A.E. (2004). Palliative care for patients with heart failure. Journal of the American Medical Association, 291, 2476–2482.Google Scholar
Pratt, C., McGuigan, W., & Katzev, A. (2000). Measuring program outcomes: Using retrospective pretest methodology. American Journal of Evaluation, 21, 341–350.Google Scholar
Riegel, B., Carlson, B., Glaser, D., et al. (2000). Which patients with heart failure respond best to mutlidisciplinary disease management? Journal of Cardiac Failure, 6, 290–299.Google Scholar
Rosenstein, A. (2002). Nurse–physician relationships: Impact on nurse satisfaction and retention. The American Journal of Nursing, 102, 26–34.Google Scholar
SAS Institute Inc. (2004). SAS/STAT 9.1 User's Guide. Cary, NC: The SAS Inc.
SAS Institute Inc. (2005). The SAS System for Windows. Cary, NC: The SAS Inc.
Sullivan, A.M., Lakoma, M.D., Billings, J.A., et al. (2005). Teaching and learning end-of-life care: Evaluation of a faculty development program in palliative care. Academic Medicine, 80, 657–668.Google Scholar
Teno, J.M., Weitzen, S., Fennell, M.L., et al. (2001). Dying trajectory in the last year of life: Does cancer trajectory fit other diseases? Journal of Palliative Medicine, 4, 457–464.Google Scholar
von Gunten, C.F., Ferris, F.D., & Emanuel, L.L. (2000). Ensuring competency in end-of-life care: Communication and relational skills. JAMA, 284, 3051–3057.Google Scholar
von Gunten, C.F. & Weissman, D.E. (2002). Discussing do-not-resuscitate orders in the hospital setting: Part 2. Journal of Palliative Medicine, 5, 417–418.Google Scholar
Washington Home Center for Palliative Care Studies, A Division of the RAND Corporation (2002). Living with Advanced Congestive Heart Failure: A Guide for Family Caregivers November 2002, Palliative Care Policy Center, Arlington, VA.
Tomey, A. (2003). Learning with cases. The Journal of Continuing Education in Nursing, 34, 34–38.Google Scholar
Wenrich, M.D.,, Curtis, J.R., Shannon, S.E., et al. (2001). Communicating with dying patients within the spectrum of medical care from terminal diagnosis to death. Archives of Internal Medicine, 161, 868–874.Google Scholar
Wilkinson, S.M., Gambles, M., & Roberts, A. (2002). The essence of cancer care: The impact of training on nurses' ability to communicate effectively. Journal of Advanced Nursing, 40, 731–738.Google Scholar
Zapka, J., Hennessy, W., Carter, R., et al. (2006). End-of-Life communication and hospital nurses: An educational pilot. Journal of Cardiovascular Nursing, 21, 3, May–June 2006 223–231.Google Scholar