INSPIRING CHANGE: Compassionate care: A focus on dying well
Jo Ann Goodie RN
Gayle McGlory MSN, RN-BC

May 2010 
Volume 40  Number 5
Pages 12 - 14
  PDF Version Available!

MORE THAN 2.4 MILLION people die in the United States each year and approximately 80% of them die in hospitals.1,2 Healthcare workers need a multidisciplinary approach to effectively meet the needs of terminally ill patients.This article describes how our hospital developed an educational program for nurses and healthcare providers to promote dignity and quality of life for terminally ill patients. The program uses best practices to improve end-of-life care and ensure patients are empowered to actively develop end-of-life goals. We then shared our program with the other two hospitals in our district. Our district, a nonprofit organization supported by county taxes, provides care regardless of patients' ability to pay.During one 3-month period in 2004, six patients died on the gynecologic oncology service. The transition from curative to palliative care was a complicated process for patients, families, and the healthcare team. We discussed the staff's limited experience with terminally ill patients and family members at our council meeting and created a multidisciplinary team (the Compassionate Care Team) in February 2005 to address this concern. We used DiCenso and colleagues' evidence-based clinical decision model to guide the projected plan.3The Compassionate Care Team included the gynecologic oncology nurse coordinator, obstetrics/gynecology clinic nurse manager, clinical nurse case manager, radiotherapy services, spiritual care services, gynecologic oncology attending physician, pharmacist, nursing supervisor, and inpatient staff/management representatives.We needed a plan of action that employed best practices and allowed patients to contribute.4-6 Impromptu communication from dying patients and their families had shown us we needed active listening skills to better understand their needs.We searched PubMed and Ovid databases for relevant studies published from 2004 to 2008. The key words we used were end-of-life care, palliative care, cancer, and

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