Lynn Mackinson, Sharon O’Donoghue, Priscilla Gazarian, Kathleen Turner; Beth Israel Deaconess Medical Center, Boston, MA

Symptom management in the intensive care unit (ICU) at the end of life (EOL) requires specialized knowledge and skill, with nurses playing an integral role in providing quality patient/family-focused care. The study purpose was to identify factors related to ICU nurses’ comfort with one domain of EOL care, pain management, including knowledge of guidelines, education, and experience with EOL care. A second goal was to compare documentation of pain management at the EOL with adherence to institutional guidelines.

One-fifth of Americans die during or shortly after an ICU stay, with patients often suffering pain at the EOL. Mularski et al identified 18 metrics to assess quality EOL care, including 2 that address pain assessment and management. Inadequate education has been identified as a barrier to quality EOL care....

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