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The impact of a Serious Illness Conversation Guide training workshop for registered nurses in the intensive care unit : a feasibility randomized control trial

University of British Columbia

Background: Serious illness conversations between health care providers and patients are necessary so that patients experiencing life-threatening illnesses receive health care in line with their values and preferences. Registered nurses (RNs) in intensive care units (ICUs) are well positioned to engage in these conversations but may feel unprepared to navigate these discussions. The Serious Illness Conversation Guide (SICG) was developed to help physicians and nurse practitioners conduct better quality serious illness conversations. To date, there is a gap in evidence to support its use by RNs and in the ICU environment. Purpose: To evaluate the acceptability of the SICG communication training workshop for ICU RNs and to evaluate the feasibility of a randomized control trial study examining the impact of the SICG workshop on ICU RN confidence, attitudes, and engagement in serious illness conversations. Methods: This multiple methods feasibility study used qualitative and quantitative descriptions of the workshop, participation, implementation factors, and acceptability to assess feasibility. Self-reported questionnaires were employed to evaluate the impact of the SICG workshop on RN confidence, attitudes, and engagement in serious illness conversations. Results: The study recruitment rate was low (3.6%) resulting in a small sample size (N = 8). This was due to multiple factors at the systems and RN levels. The SICG workshop was acceptable to ICU RNs where all participants rated the workshop positively (≥ 8/10). Conducting the workshops, adequate participation in data collection measures, and identification of facilitators and barriers to successful study implementation were feasible. Participants reported increased confidence and attitudes scores post intervention but engagement in conversations remained low. Conclusion: The low recruitment rate of this study causes concern for the feasibility of this randomized control trial study design. Achieving increased ICU RN participation in the SICG workshop may need to take place outside of the research context. The generalizability of the findings is limited by the study design and results. Future research is needed to address the challenges encountered and to determine strategies to augment and sustain the uptake of the SICG communication strategy among ICU RNs.

Text

2019-11-08

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/72233

Nursing

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/