Date on Paper

7-2021

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Harrington, Candace

Committee Member

Leinenbach, Angela

Author's Keywords

end-of-life; palliative care; long-term care; good death; spiritual well-being; value-based care

Abstract

Purpose: The goal of this Doctor of Nursing Practice (DNP) project was to develop and evaluate an evidence-based clinical practice guideline (EBP) for an interprofessional approach across four end-of-life care domains (1) ethnocentric spiritual wellbeing, (2) mental wellbeing, (3) symptom management, and (4) value-based goals of care. Design and Methods: The Iowa Model for the Development of Evidence-Based Practice guided the development of the practice guideline. A multi-phase literature review was conducted to establish and grade the best evidence. A two-phase evaluation plan was developed. The University of Louisville Institutional Review Board approved the project. Results: In evaluation phase one, a long-term care interprofessional expert consensus panel evaluated six domains of rigor of the clinical practice guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to establish face and content validity. The 70% AGREE II benchmark was exceeded after the first round (87.2%) with revisions based on expert panelist recommendations. In phase two, an anonymous electronic 10-question Modified Practitioner Feedback Questionnaire (MPFQ; α = .889) was distributed with the guideline using convenience and snowball sampling. Twenty-two long-term care professionals found the guideline acceptable with a 92.7% aggregate approval rate. Implications for Practice: This guideline provides a systematic and evidence-based interprofessional approach to person-centered end-of-life care in the long-term care setting. The provision of person-centered ethnocentric end-of-life care that incorporates spiritual and mental well-being may improve care quality and resident satisfaction ratings.

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