Abstract

Although advances in medical technology have increased the average lifespan of the elderly population, many patients do not receive assistance at the end of life, and suffer with avoidable pain and distress. Practitioners and researchers have identified the need for further research to improve the quality of EOLC. Research shows that the NP may be the best choice of hospital staff to initiate EOLC discussions and decisions with patients and their families. For this reason, it is likely that the role of the NP in EOLC will expand to a specialty focus in the near future. Therefore, the purpose of this evidence-based practice project was to develop a nurse practitioner knowledgebase regarding the role of the NP in EOLC. The research questions generated for the scope of the investigation asked: (a) what is the level of healthcare knowledge regarding end of life care?, (b) according to the literature, what is the role of the NP in EOLC? A Boolean computer search of nursing and medical literature for theory-based, data-based, randomized controlled trials for citations utilizing CINAHL, MEDLINE, and the Cochrane Library was conducted for this systematic review. Jean Watson’s nursing philosophy of human caring (1979,1985 & 1988) served as the theoretical foundation for this clinical project and guided the systematic review through data collection of the healthcare literature. EOLC is unique to the culturally diverse human and encompasses a variety of different perspectives for the patient, family, healthcare provider, as well as society as a whole. Using an Evidence Based Medicine (EBM) approach, based on that of Sackett, Straus, Richardson, Rosenberg, and Haynes (2000), a knowledgebase was developed according to methods described by Davidson (2003), in which key findings from the systematic review of randomized control trials, data-based and theory-based literature were compared to available current practice guidelines, resulting in best practice recommendations. These recommendations emphasize the necessity for components of EOLC that are patient-specific and individualized. The need for further attention to the role of the NP in EOLC is critical. Evidence-based practice modalities that will utilize current perspectives of the NP in EOLC are essential for the good death experience.

Degree

Master of Science in Nursing (MSN)

Department

Graduate Nursing

Degree Date

7-31-2006

Publication Number

27919795

First Advisor

Dr. Brenda Smith

Second Advisor

Dr. Sandra Kirkland

Document Type

Thesis

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