Over half of nurses rate their hospital's end-of-life care unfavorably, study finds

Most nurses — 58 percent — rate their hospital's end-of-life care unfavorably, and they may hold the key to improving care quality, a study published in the Journal of the American Geriatrics Society found.

"Even the best hospitals have significant room for improvement when it comes to providing better care for patients at the end of life," said lead study author Karen Lasater, PhD, RN. "Hospitals are failing to capitalize on an already available cadre of skilled end- of-of-life care providers available for every patient in every hospital — registered nurses at the bedside."

The study, conducted by researchers at the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research in Philadelphia, describes the quality of end-of-life care in about 500 U.S. hospitals, using nearly 13,000 bedside nurses to inform care quality. 

The most common quality issue nurses cited (53 percent of nurses) is patients in their hospital often undergo painful procedures that probably won't change their clinical outcome. 

Additionally, more than one-third (37.7 percent) of nurses say they are discouraged from discussing alternative care options with patients and their families. A similar percentage of nurses reported they often don't agree with their physician colleagues about end-of-life care decisions and feel these decisions are not made as a team.

End-of-life care is best in hospitals with effective nurse-physician teamwork, the study found. In these hospitals, authority is delegated to nurses to act on their expertise; nurses have manageable workloads; and nurses are actively engaged in hospital decision-making.

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