Investigating the educational needs of licensed nursing staff and certified nursing assistants in nursing homes regarding end-of-life care

Abstract Background Nursing homes are becoming more important for end-of-life care. Within the industrialised world, Germany is among the countries with the most end-of-life hospitalizations in nursing home residents. To improve end-of-life care, investigation in the status quo is required. The objective was to gain a better understanding of the perspectives of nursing home staff on the current situation of end-of-life care in Germany. Methods A cross-sectional study was conducted as a postal survey among a random sample of 1069 German nursing homes in 2019. The survey was primarily addressed to nursing staff management. Data was analyzed using descriptive statistics. Staff was asked to rate different items regarding common practices and potential deficits of end-of-life care on a 5-point-Likert-scale. Estimations of the proportions of in-hospital deaths, residents with advance directives (AD), cases in which documented ADs were ignored, and most important measures for improvement of end-of-life care were requested. Results 486 (45.5%) questionnaires were returned, mostly by nursing staff managers (64.7%) and nursing home directors (29.9%). 64.4% of the respondents rated end-of-life care rather good, the remainder rated it as rather bad. The prevalence of in-hospital death was estimated by the respondents at 31.5% (SD: 19.9). Approximately a third suggested that residents receive hospital treatments too frequently. Respondents estimated that 45.9% (SD: 21.6) of the residents held ADs and that 28.4% (SD: 26.8) of available ADs are not being considered. Increased staffing, better qualification, closer involvement of general practitioners and better availability of palliative care concepts were the most important measures for improvement. Conclusions Together with higher staffing, better availability and integration of palliative care concepts may well improve end-of-life care. Prerequisite for stronger ties between nursing home and palliative care is high-quality education of those involved in end-of-life care.

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Certified Nursing Assistants' Knowledge, Confidence, and Effectiveness in Providing End-of-Life Care

10.28971/532011fc112 ◽

2011 ◽

Cited By ~ 1

Author(s):

Carol Falcone

Keyword(s):

End Of Life ◽

Rhode Island ◽

End Of Life Care ◽

Quality Care ◽

Nursing Assistants ◽

Certified Nursing Assistants ◽

Life Care ◽

Nursing Assistant ◽

Term Care ◽

Provide Quality Care

<p>The objective of this research was to explore the knowledge, confidence and effectiveness level of certified nursing assistants (CNAs) working with persons at end-of-life (EOL). This study was a descriptive, one-dimensional study that was conducted at a long term care (LTC) facility in Rhode Island. Participants answered demographic and confidence questionnaires and completed a short exam. The participants regularly provided care for persons at EOL, but received no additional training in that specialty. The 20 participants were fro,m diverse backgrounds and cultures. The study was conducted over two months and results indicated perceived confidence and effectiveness levels higher than knowledge scores. Over fifty percent of the participants received a score of less than 70% on the knowledge exam. There were multiple findings that implied a need for further research. The number of individuals receiving EOL care in nursing homes has escalated over the past decade. To provide quality care to the terminally ill, including general comfort, pain relief, spiritual, and emotional support, it must be provided by qualified nursing assistants. It is the premise of the researcher that nursing assistants who provide the majority of care to patients at EOL require specialized training to meet both nursing assistant and patient needs. The findings from this study support this premise and have implications for research and practice in end-of-life care.</p>

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