Developing a decision making tool for nurses to improve end of life skin care for advanced cancer patients: a qualitative exploratory study

Samuriwo, Raymond ORCID: https://orcid.org/0000-0001-5954-0501, Henley, Josephine, Anstey, Sally ORCID: https://orcid.org/0000-0003-2295-3761, Job, Claire ORCID: https://orcid.org/0000-0003-1690-3143 and Hopkinson, Jane ORCID: https://orcid.org/0000-0002-3915-9815 2018. Developing a decision making tool for nurses to improve end of life skin care for advanced cancer patients: a qualitative exploratory study. Presented at: 20th Annual Meeting of European Pressure Ulcer Advisory Panel (EPUAP 2018), Rome, Italy, 12-14 September 2018.

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Abstract

Introduction: The need to improve the quality of skin care for patients at the end of life has been highlighted in a number of reports (1). Nurses are said to have difficulties in making decisions about skin care because it may cause distress to a dying patient or their family. This study sought to develop a decision making tool (DMT) to help nurses to make appropriate decisions about the end of life skin care for patients with advanced cancer in hospitals. Methods: A qualitative case study design was used to gather data through a triangulation of methods. This study gathered data through focus group interviews with 17 bereaved family members and nurses, 440 hours of non-participant observation on two hospital wards that deliver care to advanced cancer patients approaching the end of life as well as individual interviews with 12 key informants who were identified during the non- participant observation. Data were subject to thematic analysis informed by shared decision making theory (2, 3). Results: We found that nurses’ decisions about end of life skin care for patients with advanced cancer are influenced by a number of individual, organisational, patient and family factors or cues. We also found that each nurse makes decisions about end of life skin care collectively with other nurses, healthcare professionals and clinical staff. We have also developed a theory and DMT which takes into account the fact that a nurse’s decision making about end of life skin care is a reflective, iterative, continuous process in which nurses take into account a number of factors and cues in clinical practice. Conclusions: Our findings are consistent with wider literature on nurses skin care related decision making and general end of life care, but there are two novel findings. Firstly, nurses make and constantly review their judgements and decisions about end of life skin care with other nurses and healthcare professionals. Secondly, we found that each nurse makes decisions about the prioritisation and delivery of end of life skin care collectively with other nursing staff. Our DMT and theory can be integrated into logic models that are used in quality improvement projects and interventions for end of life skin care. This paper will describe the development of the end of life skin care DMT and theory.

Item Type:	Conference or Workshop Item - unpublished
Status:	Unpublished
Schools:	Schools > Healthcare Sciences
Last Modified:	05 Nov 2026 15:29
URI:	https://orca.cardiff.ac.uk/id/eprint/140584

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