Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Susan Hayden

Abstract

Hospice patients use the emergency department (ED) for the management of symptoms, making it necessary for ED nurses to be equipped with the knowledge and skills to care for hospice patients. EDs should have staff specially trained to address end-of-life needs due to ED staff’s minimal knowledge of treating and managing hospice patients. When healthcare organizations fail to provide clinical practice guidelines (CPG) and collaborate with significant stakeholders adequately, gaps in care delivery can occur, and hospice care is often not delivered safely. Standardized guidelines on end-of-life care in the ED should provide adequate guidance for ED nurses in bridging the gap to improve end-of-life care in the ED. Based on peer-reviewed articles from Cochrane Database of Systematic Reviews, PubMed, and MEDLINE and the AGREE II model, the DNP student addressed the gap in practice by creating a CPG following Walden University’s CPG manual and the AGREE II model, answering the practice-focused questions and providing ED nurses with resources to improve hospice care in the ED. A panel of three content experts with experience in both hospice and emergency medicine evaluated the newly developed CPG finding it of high quality with no revisions needed. Domain scores ranged from 90% for rigour of development and 98% for scope and practice with an overall domain score of 100% usable CPG. These newly developed guidelines should provide a positive social change through improved hospice care in the ED thus putting the patients and families at ease and allowing them to focus on themselves and their loved ones. Furthermore, cost-savings are anticipated due to the reduced uncertainty in care practice and a more efficient discharge process from the ED.

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