After watching patients, families and health care providers grapple with ethical and medical issues surrounding dying patients, a group of staff members at the Mayo Clinic Hospital (MCH) in Phoenix, AZ, decided to find a better way.
They launched a study on whether a palliative care program, focusing on easing pain and symptoms, not curing diseases, would better meet patients' and families' wishes, while also reducing the psychological and financial costs that often arise when life-saving medical interventions are used.
In the June 2007 issue of MEDSURG Nursing, Elizabeth Rice and Denise Betcher describe MCH's journey toward more humane end-of-life care. The researchers studied data from the facility's records for patients who died from January 2000 to December 2002. They also surveyed MCH nurses, physicians and other health care practitioners about their perceptions of such cases. The research showed the practitioners believed they were inadequately prepared for end-of-life patients and they wanted more education about appropriate care. Results also showed many patients were given excessive testing in their final 48 hours and suffered transfers to multiple units in efforts to save their lives.
An MCH Palliative Care Committee was appointed and a 1-year palliative care pilot program conducted. After presenting the data from the pilot, which supported the original study, MCH's Board of Governors agreed to implement an official Palliative Care Consultation Service staffed by a multidisciplinary team to improve care. Nurses are developing education programs and collaborating with a local hospice center. Preliminary data will be available in 2008. (Evidence Base for Developing a Palliative Care Service; Elizabeth M. Rice, MSN, RN, and Denise K. Betcher, MSN, RN, CHPN; MEDSURG Nursing, June 2007 )
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