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  1. Myers, Joan Carr MA, BCC, LMT
  2. Hyrkas, Kristiina PhD, MNSc, LicNSc, RN


This quality improvement initiative originated in the cardiac intensive care unit (CICU) at a 637-bed licensed Magnet teaching hospital with the rating of level 1 trauma center. The CICU has 12 beds, with a staff of 59 nurses (RNs). The nursing staff expressed increased stress and discomfort when communicating with patients and their families when providing end-of-life care. Selected evidence-based techniques for stress reduction and active listening skills were taught in 4- to 5-minute mini sessions during the morning huddle 3 days per week for 4 weeks. The program was evaluated using pretest, posttest, and 2 follow-up surveys composed of 5 statements and 2 open-ended questions. The survey tool was developed by researchers in accordance with the relevant literature. The results showed improved communication as demonstrated by the surveys. Nurses also reported feeling more supported by their colleagues and supervisors. The project was conducted in 1 CICU, therefore limiting the generalizability of the results.