Providers’ Knowledge, Attitudes and Willingness to Use an End-of-Life Protocol on an Inpatient Oncology Unit

Abstract

Objective: The purpose of this Doctor of Nursing (DNP) project was to examine providers’ knowledge, attitude, and willingness to use an end-of-life care protocol on an inpatient unit. Background: Cancer is second leading cause of mortality in the United States and despite increases in hospice and palliative care services, many cancer patients at end-of-life are dying in the hospital setting. Research shows the use of an end-of-life care protocol set increases patient care outcomes and increases provider satisfaction with end-of-life care, however; they are not being utilized in many hospitals. The National Consensus Project (NCP) for quality palliative care published evidence based clinical practice guidelines as a set of standards for improving the quality of patient care specifically at end-of-life. There is very little research that examines determinants related to providers’ knowledge, attitudes, and willingness to use an end-of-life care protocol based on the clinical practice guidelines established by the NCP. Methods: Qualitative descriptive research study consisting of a electronic survey questionnaire. Setting: Large cancer facility in Goodyear, Arizona. Participants: Sample of 21 out of 35 providers that included hospitalists, physicians, oncologists, nurse practitioners, and physician assistants. Conclusions: Providers were not knowledgeable regarding the NCP’s clinical practice guidelines for end-of-life care, but their attitudes strongly favor the six suggested practice guidelines for actively dying patients, and they were somewhat willing to adopt these practices. There was also a moderate correlation between the number of years worked with end-of-life patients and the providers’ willingness to learn more about and to use end-of-life care protocols in their practice.