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Background Communication problems between family surrogates and intensive care unit (ICU) clinicians have been documented, but few interventions are effective. Nurses have the potential to play an expanded role in ICU communication and decision making. Objectives To conduct a pilot randomized controlled trial of the family navigator (FN), a distinct nursing role to address family members' unmet communication needs early in an ICU stay. Methods An interprofessional team developed the FN protocol. A randomized controlled pilot intervention trial of the FN was performed in a tertiary referral hospital's ICU to test the feasibility and acceptability of the intervention.The intervention addressed informational and emotional communication needs through daily contact by using structured clinical updates, emotional and informational support modules, family meeting support, and follow-up phone calls. Results Twenty-six surrogate/patient pairs (13 per study arm) were enrolled. Surrogates randomized to the intervention had contact with the FN on 90% or more of eligible patient days. All surrogates agreed that they would recommend the FN to other families. Open-ended comments from both surrogates and clinicians were uniformly positive. Conclusions Having a fully integrated nurse empowered to facilitate decision making is a feasible intervention in an ICU and is well-received by ICU families and staff. A larger randomized controlled trial is needed to demonstrate impact on important outcomes, such as surrogates' well-being and decision quality. [ABSTRACT FROM AUTHOR]

Dignity Therapy (DT) is an intervention designed to lessen existential suffering as death draws near. DT has a growing evidence base, with positive outcomes for patients and their family members; however, it is not yet widely available in community settings. The purpose of this project was to translate DT into clinical practice in a cancer center in the midwestern United States. DT was provided to 10 patients with metastatic cancer who completed baseline and post-intervention measures of depression, existential distress, health-related quality of life, and satisfaction with the intervention. DT was found to be feasible and acceptable to the majority of patients and their families. DT outcomes will be presented, along with suggestions for clinicians who are interested in offering DT in their practices. [ABSTRACT FROM AUTHOR]