Development of End-of-Life Peer Nurse Coaches: A Hospital-Based Quality Improvement Project

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Abstract

New nurse hires lacked end-of-life nursing experience in the hospital, and mechanisms were unavailable to guide them. A quality improvement project was developed to address this. Seventy-three registered nurses representing 39 nursing units received training as end-of-life peer nurse coaches. This training included 2 hours of end-of-life education and 2 hours of communication/simulation training. Coaches were provided with communication prompt cards, a Nurse to Nurse: Palliative Care book, and additional resources. The outcome of the project on peer nurse coach self-perceived competency was measured using an abridged version the Scale of End of Life Care in the ICU tool before and after training, at 6 months, and at 1 year. A report card was used to record coaching activities at 6 months, and a survey was conducted to evaluate these activities at 1 year. Peer nurse coach self-perceived competencies in end-of-life care delivery improved after training, at 6 months (P < .01), and at 1 year (P < .05). Qualitative findings highlighted various ways peer nurse coaches manifest these new roles. The plan-do-study-act method, the peer nurse coach approach, availability of unit-based end-of-life resources, and peer nurse coach mentoring had positive effects on peer nurse coach self-perceived end-of-life competence and their abilities to coach new nurse hires.

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