Evaluating Schwartz Center Rounds in an urban hospital center.

PURPOSE: Schwartz Center Rounds (SCRs) bring multidisciplinary caregivers together to discuss authentic patient cases from the social and emotional perspective. The monthly sessions provide a forum to share personal thoughts and feelings. The purpose of this paper is to learn why people attend SCR, understand what is gained from the experience, and identify key elements to use in measuring the program's effectiveness. DESIGN/METHODOLOGY/APPROACH: This qualitative descriptive study used four focus groups and three telephone interviews for data collection. Purposive sampling resulted in a multidisciplinary sample of 30 participants. Thematic analysis was conducted with complete transcripts by all researchers. FINDINGS: All parties viewed SCR as beneficial. Six themes emerged during data analysis: culture change, exposing emotions, walking in another's shoes, inequality of topics, influence of rules and boundaries, and personal impact. Institutional culture was positively influenced through SCR. RESEARCH LIMITATIONS/IMPLICATIONS: Limitations include a single institution and restricted data gathered from physicians. Future research should focus on identifying outcome measures to evaluate the long-term impact of SCR on healthcare organizations. PRACTICAL IMPLICATIONS: This study confirms that the SCR program should be continued at the study organization, and expanded to increase availability to all staff. The growth of this program in healthcare organizations across the country is encouraged. ORIGINALITY/VALUE: This research provides support for healthcare organizations to offer SCR and highlights how the emotional aspects of patient care can be acknowledged, explored, and discussed.

End-of-Life issues and the patient with renal disease: an evidence-based practice project.

End-of-life issues affect everyone at some time. Individuals with chronic illness need to face these issues earlier to ensure their wishes are carried out. Patients with chronic kidney disease (CKD) Stage 5 have only three options: dialysis in its various forms, renal transplant, or death. In some cases, nurses who care for these patients feel they are caught between patients, their families, and the physician(s). Nurses want to help their patients but feel their hands are tied. The authors' evidence-based practice renal project team worked to answer the questions of how nurses can assist patients with end-of-life issues. Do patients with CKD Stage 5 receive enough information on quality of life and end-of-life issues? The evidence showed that nurses are not comfortable discussing end-of-life issues with their patients. In response to these data, several educational sessions designed to give nurses tools needed to develop a comfort level when discussing end-of-life issues with their patients were completed.