Date of this Version

12-2-2021

Document Type

DNP Project

Abstract

Background: The uncertainty of how to effectively provide bereavement support to families in the neonatal intensive care unit (NICU) is a cause of stress in nurses, often leading to feelings of sadness, grief, and professional inadequacy. One way to address this need is to provide support to nurses in the form of protocols and guidelines. The use of a guideline or protocol takes the uncertainty away from the nurse and assists them in ensuring that they are providing adequate support, especially among nurses inexperienced in providing bereavement support.

Methodology: Using a pre- and post-test design, the Plan, Do, Study, and Act (PDSA) cycle was used to guide this quality improvement project. Participants were recruited via purposive sampling method. Twelve nurses were included in the study. Participants were educated on the developed NICU specific evidenced-based bereavement guideline via a one hour, online educational session. Participants were asked to fill out a demographics and professional form and a pre- and post-intervention survey, the Bereavement/End of Life Attitudes About Care of Neonatal Nurses Scale (BEACONNS) by Engler et al. (2004). The BEACONNS assesses comfort, role, and involvement in bereavement and end of life care.

Results: A paired samples t-test indicated the post-intervention mean comfort scale scores, M = 4.17, SD = 0.35, and post-intervention mean role scale scores, M = 4.23, SD = 0.41, were significantly higher than the pre-intervention mean comfort scale scores, M = 3.33, SD = 0.72, with a t-score of 3.70 and p-value of 0.003 (p<0.05), and pre-intervention mean role scale scores, M = 3.77, SD = 0.52, with a t-score of 5.70 and p-value of 0.0001 (p<0.05). A Wilcoxon signed ranks test shows that the post-intervention involvement scale median scores, Median = 5, was significantly higher than the pre-intervention involvement scale median scores, Median = 4.25, with a Z-score of 2.45 and p-value of 0.01 (p<0.05).

Conclusions: The positive increases in mean scores on the BEACONNS reflect that the implementation of a bereavement guideline was effective in increasing nurses’ comfortableness in providing bereavement support to families in the neonatal intensive care unit. The results of the QI project reflect the need for education amongst nurses about bereavement interventions and its importance to families experiencing neonatal loss.

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