Evaluation of a Peer Nurse Coach Quality Improvement Project on New Nurse Hire Attitudes Toward Care for the Dying

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Abstract

Despite growth of hospices in the United States, there is increased use of intensive care and late referrals to hospice, and most patients die in hospitals. A national survey indicates that these patients can experience persistent pain, dyspnea, anxiety, and depression, and they and their families also have unmet needs for respectful treatment. Nursing leaders perceived that new nurse hires lacked end-of-life training and were uncomfortable caring for dying patients. Evidence from 2009 to 2011 using Frommelt Attitudes toward Care of the Dying (FATCOD) questionnaires collected during classroom exercises confirmed this and indicated areas for quality improvement. After further review, a peer nurse coach model was selected for the intervention. New nurse hire FATCOD data from 2009 to 2011 were used to design the intervention. This article examines FATCOD data collected immediately before the quality improvement project and data collected 5 months after to evaluate the impact of end-of-life peer nurse coaching on new nurse hire attitudes toward end-of-life care. The difference in total scores was not significant, although there were significant positive improvements in individual questionnaire items. Overall, the peer nurse coach model holds promise as a mechanism for engaging new nurse hires and for improving end-of-life care.

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