Barriers to ideal palliative care in multiple care settings: The nurses' point of view

Abstract

Background: Nurses and certified nursing assistants (CNA) have a crucial role in 24/7 continuity of palliative care for many vulnerable patients and families, however, their perspective has been largely omitted in reported barriers to palliative care. Aim: To describe barriers to ideal palliative care that are specific to nurses and CNAs working in all care settings. Methods: A cross-sectional, online survey was distributed to members of the Dutch Nurses' Association. Findings: Almost 50% of the participating 2377 nurses and CNAs experienced more than five barriers to ideal palliative care in their work situation; nurses and CNAs employed in regional hospitals, mental healthcare and nursing home settings encountered more barriers than those working in other settings. Conclusion: The three most common barriers were: lack of proactive care planning, lack of internal consultation possibilities and lack of assessment of care recipients' preferences and needs for a seamless transition to another setting.