Implementing Therapeutic Communication Strategies in Hospice Care as a Palliative Measure

Abstract

Purpose: The purpose of this quality improvement project is to equip hospice nurses with evidence-based therapeutic communication strategies that will inform their interactions and enable them to have effective communication encounters with patients and their caregivers. Background: Effective therapeutic communication is essential for promoting better decision-making in end-of-life care and relieving patient and caregiver burden. Sage Hospice is a program based in Scottsdale, Arizona, which provides hospice care to Maricopa County patients. Sage’s score for effective Communication with Family as measured by CAHPS, was 81 out of 100 from January 1, 2018, through December 31, 2019. Considering advanced nursing practice’s hallmark focus on patient education, devising a strategy to improve nurse-patient communication, and subsequently this score, is imperative. Methods: An educational in-service presentation was provided to Sage Hospice nurses that focused on utilizing effective therapeutic communication strategies to inform nurse-patient encounters. Hospice nurses’ responses to the therapeutic communication education, including increased knowledge, confidence, and intent to use the presented knowledge in real-life patient encounters, were evaluated. A descriptive, quantitative approach was utilized to ascertain the educational in-service session's effectiveness. Results: A total of 21 hospice nurses participated in the in-service and completed the post-survey. A high response rate (52.5%) was achieved as 21 out of the 40 invited nurses participated. After participating in the in-service, most participants either “agree” or “strongly agree” with the statement that they achieved increased knowledge, confidence, and intent to use the presented information in their future patient encounters. Conclusions: The in-service educational presentation regarding the use of therapeutic communication strategies in hospice care was an effective way to increase hospice nurses’ knowledge, confidence, and intent to use the learned information in their day-to-day patient encounters. Future key recommendations include updating the educational content with the latest evidence-based knowledge, developing a plan for face-to-face delivery of the in-service as soon as regulatory guidelines permit, and providing printed pamphlets with therapeutic communication tips to future in-service participants.