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

Usher, Barbara M. PhD, RN, ACHPN, GCNS-BC; DiNella, Jeannine DNP, RN, CCNS; Ren, Dianxu PhD, MD; Liang, Zhan MSN, RN; Tuite, Patricia K. PhD, RN, CCNS

Journal of Hospice & Palliative Nursing: December 2015 - Volume 17 - Issue 6 - p 551–558
doi: 10.1097/NJH.0000000000000198
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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.

Barbara M. Usher, PhD, RN, ACHPN, GCNS-BC, is programmatic nurse specialist, Palliative and Supportive Care, University of Pittsburgh Medical Center, Pennsylvania.

Jeannine DiNella, DNP, RN, CCNS, is programmatic nurse specialist, Cardiovascular Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Dianxu Ren, PhD, MD, is associate professor and associate director for statistical support, University of Pittsburgh, Pennsylvania.

Zhan Liang, MSN, RN, is doctoral candidate, School of Nursing, University of Pittsburgh, Pennsylvania.

Patricia K. Tuite, PhD, RN, CCNS, is assistant professor, Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pennsylvania.

Address correspondence to Barbara M. Usher, PhD, RN, ACHPN, GCNS-BC, Palliative and Supportive Care, University of Pittsburgh Medical Center, UPMC Montefiore, 933 W, 200 Lothrop St, Pittsburgh, PA 15213 (usherbm@upmc.edu).

Funding was provided by The Beckwith Institute in partnership with the University of Pittsburgh Medical Center.

The authors have no conflicts of interest to disclose.

© 2015 by The Hospice and Palliative Nurses Association.