title: ICU Bedside Nurses' Involvement in Palliative Care Communication: A Multicenter Survey.
abstract: BACKGROUND
  Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses.
  
  
  OBJECTIVE
  To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication.
  
  
  METHODS
  A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via e-mail in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, U.S.
  
  
  RESULTS
  The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%).
  
  
  CONCLUSIONS
  ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.
authors.affiliation: Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA. Electronic address: Wendy.Anderson@ucsf.edu.
authors.forename: Wendy G
authors.initials: WG
authors.lastname: Anderson
authors.affiliation: Department of Physiological Nursing, University of California San Francisco School of Nursing, San Francisco, California, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Puntillo
authors.affiliation: University of California, Irvine Health, Orange, California, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Boyle
authors.affiliation: University of California, San Francisco Medical Center, San Francisco, California, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Barbour
authors.affiliation: University of California, San Francisco Medical Center, San Francisco, California, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Turner
authors.affiliation: Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA.
authors.forename: Jenica
authors.initials: J
authors.lastname: Cimino
authors.affiliation: University of California, Davis Medical Center, Sacramento, California, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Moore
authors.affiliation: University of California, Davis Medical Center, Sacramento, California, USA.
authors.forename: Janice
authors.initials: J
authors.lastname: Noort
authors.affiliation: University of California, Davis Medical Center, Sacramento, California, USA.
authors.forename: John
authors.initials: J
authors.lastname: MacMillan
authors.affiliation: University of California, Davis Medical Center, Sacramento, California, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Pearson
authors.affiliation: University of California, Irvine Health, Orange, California, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Grywalski
authors.affiliation: University of California, Irvine Health, Orange, California, USA.
authors.forename: Solomon
authors.initials: S
authors.lastname: Liao
authors.affiliation: University of California, Los Angeles Medical Center, Los Angeles, California, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Ferrell
authors.affiliation: University of California, Los Angeles Medical Center, Los Angeles, California, USA.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Meyer
authors.affiliation: University of California, Los Angeles Medical Center, Los Angeles, California, USA.
authors.forename: Edith
authors.initials: E
authors.lastname: O'Neil-Page
authors.affiliation: University of California, San Diego Medical Center, San Diego, California, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Cain
authors.affiliation: University of California, San Diego Medical Center, San Diego, California, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Herman
authors.affiliation: University of California, San Diego Medical Center, San Diego, California, USA.
authors.forename: William
authors.initials: W
authors.lastname: Mitchell
authors.affiliation: Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, California, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Pantilat
mesh_terms: D003142:Communication; D064648:Critical Care Nursing / Q000379:methods; D006801:Humans; D024802:Nurse's Role; D009726:Nurses / Q000523:psychology*; D010166:Palliative Care / Q000379:methods; D062606:Tertiary Care Centers
keywords: Critical care nursing; family; interdisciplinary communication; palliative care