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Introduction - Critical care nurses frequently engage in the provision of end-of-life care (EOLC). Identification of factors associated with specific EOLC practices can inform practice development to improve the care that patients and their families receive and support nurses in the provision of this care. Objectives - To identify factors associated with critical care nurses’ engagement in six areas of EOLC practice: Information sharing, environmental modification, emotional support, patient and family centred decision making, symptom management and spiritual support. Methods - Using data obtained from a national survey of 392 critical care nurses (response rate 25%), univariate general linear models were built for each EOLC practice area. Results - Findings revealed that more positive scores on scales reflecting palliative values and support for patient and family preferences were associated with more frequent engagement in the EOLC practices examined in this study. Nurses who reported higher levels of preparedness and access to opportunities for knowledge acquisition were more likely to report engaging in interpersonal practices that supported patient and family decision making and emotional support of patients and their families. Contextual factors had a limited influence as explanatory variables. Conclusions - Critical care nurses’ personal values are at the core of their practice intentions. Development of positive values among nurses towards EOLC can thus contribute to quality care for patients and their families. Additionally, education opportunities to enhance preparation and strategies that assist critical care nurses to support patient and family preferences will contribute to increased participation in the EOLC practice areas identified in this study.

Introduction - To improve the care that dying patients and their families receive and to support nurses in the provision of this care, it is important that the end-of-life care (EOLC) practices of critical care nurses are identified. Limited research has identified the actual EOLC practices of critical care nurses. Objectives - To identify critical care nurses’ EOLC practices and the frequency of these practices. Methods - A convenience sample of ACCCN members was invited to complete an online survey. Items on the survey were measured on a 5-point rating scale where 1=never and 5=always. Descriptive analyses and exploratory factor analysis was undertaken on survey responses from 392 critical care nurses (response rate 25%). Results - Six EOLC practice areas were identified: information sharing, environmental modification, emotional support, patient and family centred decision making, symptom management and spiritual support. The items most frequently undertaken were information sharing and environmental modification practices including answering questions (M=4.61, SD=0.58) and placing chairs around the bed (M=4.73, SD=0.51), whilst items least frequently undertaken were emotional support practices, such as encourage the family to reminisce (M=3.72, SD=0.87). Conclusion - Critical care nurses’ engage in practices to share control with and support inclusion of families experiencing death and dying. The most frequently identified EOLC practices were those that are easily implemented, practical strategies aimed at supporting the patient at the end-of-life and their family. These practices arguably require less emotional engagement by the nurse. Nurses must be adequately prepared and supported to provide comprehensive care in all areas of EOLC practice.

Critical care units are designed and resourced to save lives, yet end-of-life care (EOLC) comprises a significant component of work. Research to identify factors influencing the provision of EOLC is needed to inform the development of strategies to support nurses and improve practice.

The use of professional competency standards to assess postgraduate nursing student’s clinical performance has been in place since 2004, at the Queensland University of Technology, School of Nursing & Midwifery (SONAM) when the Graduate Certificate in Emergency Nursing degree commenced. Emergency nursing students were assessed in their workplace, using a Clinical Performance Appraisal Tool or CPAT which was based on the Australian College of Critical Care Nurses (ACCCN) Competency Standards. With the subsequent formation of a separate Emergency Nursing Course advisory group in 2007, there was a review of clinical assessment course component. The release of the 2008 CENA revised Practice Standards for the Emergency Nursing Specialist’s, led to the emergency nursing course advisory committee supporting the integration of the CENA practice standards for assessment of emergency nurses in preference to the less relevant ACCCN competency standards. The SONAM emergency nursing study area team commenced the phasing in and progression of the CENA practice standards across the two Graduate Certificate units, and Graduate Diploma and Master of Nursing (emergency) clinical major options in 2009. As some units undertaken in the degree are available to nurses in other disciplines a separate CPAT was devised for the clinical assessments according to speciality context. The team has had to carefully consider how the professional standards are integrated into the teaching and assessment of the unit and not just applied instead of the ACCCN competency standards. Professional standards for the emergency context has also helped tailor course content and learning outcomes to be relevant across a number of emergency nursing contexts in Australia. The assessment of the CPAT is undertaken at the workplace by QUT appointed clinical lecturers. Clinical lecturers need to apply and have suitable postgraduate qualification to undertake the position. The clinical lecturer support role is wel