Critical care nurses spend more time with patients and families facing the end of life than any other health care professional. Nurses are intimately involved in all aspects of end-of-life care and they are in position to address the variety of needs facing individuals at this juncture. Expert nursing care has the potential to greatly reduce the burden and distress of those at life's end and the ability to offer support for the many physical, psychological, social, and spiritual needs of patients and their families.
AACN Protocols for Practice: Palliative Care and End-of-Life Issues in Critical Care sets forth the evidence-based guidelines for providing appropriate care, whether aggressively life-saving or palliative end-of-life care. The Protocols equip critical care nurses to effectively manage the following:
family issues and intervention
withholding and withdrawing life support
communication and conflict resolution
caring for the caregiver
Additionally, the text includes a state-of-the-science review that provides guidance to critical care nurses while acknowledging the limited evidence-based research that exists.
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AACN Protocols for Practice are authoritative evidence-based practice resources for use by clinicians, educators, and researchers. Each series of protocols makes recommendations for the application, practice, and monitoring associated with a device, procedure, or practice.
These protocols are designed to promote evidence-based practice by providing the latest patient care research findings in a format that is easy to understand and integrate into clinical practice. The protocols can be used to guide care in a variety of clinical situations in acute care, progressive care, or even in the home. Each protocol is introduced by a case study, which is followed by general information about the technology, occupational hazards, ethics considerations, competency issues, and practice recommendations. Recommendations are rated according to the level of evidence that is available to support the statement. Annotated bibliographies, suggested readings, and cross references provide guidance for learning more about the specific device or patient care system.
Justine Medina, RN, MS-American Association of Critical-Care Nurses
Kathleen Puntillo, RN, DNSc, FAAN-University of California School of Nursing, San Francisco, California