Facilitating Evidence-Based End-of-Life Care

PURPOSE/OBJECTIVES: To deliver evidence-based, high-quality end-of-life care through a collaborative initiative led by geriatric and palliative clinical nurse specialists in partnership with an interdisciplinary team and hospital administration. DESCRIPTION: After identifying inconsistent end-of-life care within an academic medical center, geriatric and palliative clinical nurse specialists synthesized best practices to develop a "comfort care" initiative. Operating across the 3 clinical nurse specialists' spheres of influence, the team collaborated with administrative and interdisciplinary stakeholders to pilot the model on a specialized geriatrics unit. OUTCOMES: Implementation led to consistent use of individualized care plans, accurate pain assessments, and timely execution of EOL orders. In the designated unit, nurses achieved compliance rates of 80% to 100%, significantly outperforming other system settings. This successful pilot served as a catalyst for system-wide improvements, including the standardization of evidence-based nursing care plans, comfort care code status protocols, and end-of-life order sets throughout the hospital system. CONCLUSIONS: This project demonstrates that clinical nurse specialists-led interdisciplinary collaboration can drive sustained, significant improvements in end-of-life care quality and system-wide practice standardization.