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Interdisciplinary group ‘challenges the norms’ that improves delivery of end of life care in the ICU @ Hamilton General Hospital

  • April 8, 2016
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A group of front-line interdisciplinary team members in the ICU at the Hamilton General Hospital who serve as members on the End of Life Committee came together out of staff concern for the delivery of end of life care. Pioneers of the group-Grace Houston (RN) and Edita Hajdini (RN) with the support of Sue DiSabatino (RN) worked with the committee to create a survey, which analyzed the services provided to family and patients in the ICU from over 100 peer staff who participated in the survey. They analyzed the data collected resulting in significant findings that led to identifying key themes that translated into implementing practice changes influencing the delivery of end of life care as well as improving the patient/family experience in ICU.

Four key themes emerged from the survey requiring change included:

  • Communication
  • Patient and family experience
  • Education
  • Standardization of care

Several actions were taken resulting in implementing the following changes:

  • A very successful end of life mounted stand,
  • withdrawal of life support order sets,
  • the bedside communication tool,
  • end of life share drive,
  • end of life care cart ( very successful to improving patient and family experience),
  • guest speaker of end of life matters, and
  • Staff moral distress and designated end of life space (in the works).

It is important to note that this was the first nursing driven project that was completely unfunded and independent at HHS.

The abstract from this work was accepted and presented at the National Critical Care Forum Canada (CCCF) in the fall of 2015, and was orally presented at the Nursing Leadership Network this spring (2016). Following their presentations, the concepts have drawn great interest from organizations and physicians alike at CCCF, UFT, Trillium ICU, and the Medicine Unit at the Joseph Brant Hospital staff. Internally, the positive feedback from co-workers, managers and intensivists continues to roll in as well as the continued support from Dr. Mead, Dr. Fox-Robichaud and Ellen McDonald.

Questioning the norm drives research-the pursuit of understanding how we might do things better fuels the desire for answers. Congratulations to the nursing staff and their colleagues in Hamilton General Hospitals’ ICU for asking the tough questions that needed to be asked and then implementing changes for the betterment of all.

Grace Sue Edita

A photo of Grace, Sue and Edita with their mounted stand at the CCCF.