Most Nurses Unsatisfied With Hospitals' End-of-Life Care

The nurse practice environment was the best predictor of poor-quality end-of-life care

WEDNESDAY, Dec. 26, 2018 (HealthDay News) -- The majority of nurses have an unfavorable opinion of their hospital's end-of-life care, according to a study published online Dec. 2 in the Journal of the American Geriatrics Society.

Karen B. Lasater, Ph.D., R.N., from the University of Pennsylvania in Philadelphia, and colleagues used data from the 2016 RN4CAST-US survey of nurses (12,870 direct care registered nurses in 491 acute-care hospitals) to assess the quality of end-of-life care in U.S. hospitals and the nurse practice environment.

The researchers found that 58 percent of nurses gave their hospitals an unfavorable evaluation of end-of-life care overall and 53 percent reported that patients often experience painful procedures that were unlikely to change their outcome. The nurse practice environment was the best predictor of poor-quality end-of-life care. Compared to nurses in poor-quality environments, nurses in the best environments were less likely to rate their hospital's overall end-of-life care quality unfavorably (odds ratio, 0.45). More than one-third of nurses (37.7 percent) reported that nurses at their hospital are discouraged from discussing care options with patients, and 37.5 percent reported that nurses often disagree with physicians about end-of-life care decisions.

"Hospitals are failing to capitalize on an already available cadre of skilled end-of-life care providers available for every patient in every hospital -- registered nurses at the bedside," Lasater said in a statement.

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