Understanding Nurse Graduate In Acute Care Settings Assessment 2 Answer

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Question :

Assessment 2 -- Written Assignment of 1200 words 

You are a recent graduate with two years' experience in an acute care setting. You have taken a position as a home health care nurse, and you have several adult patients with various medical conditions. However, you have recently been assigned to care for hospice patients. You do not have experience in this area, and you have not experienced a loved one at the end of life who has received hospice care. You notice that some of the family members or caregivers of patients in hospice care are withdrawn. You are wondering what the family caregivers are going through so that you might better understand the situation and provide quality care. . Identify the research problem in the sceLrio. 2. Clearly formulate the four/five components of each RICO (1) question in a table format (named it Table 1) related to the

3. Identify 2 databases to begin your literature search for evidence. 4. Choose one database only, to be shown in the table (named it Table 2) and explain search strategies to find the relevant literature. (no reference is required in this assignment) 5. Identify 2 evidence from your search that are relevant to your scenario. 6. Briefly describe the first 2 steps (ask and acquire) of Evidence-based Practice relevant to your scenario.

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Answer :


The purpose of the assignment, is to understand as the nurse graduate in acute care settings and recently taken care of hospice patients (Reeves, 2019). Like hospice care, it is important to provide the best care to the end of life patient's families.  The problem lies in the anticipation of the end of the life care for the loved ones', involving the family members to provide care and how as the nursing duty, one can provide the best hospice care to such patients.

Research problem

In the given case scenario, the research problem is to focus on how to involve the family member in providing the best hospice care (Haverhals, 2019). As the home health care nurse and having an experience in the acute settings, recently with the assigned care of the hospice patients who would be treated with the end of life treatment. In such a case scenario, it is important to understand how family caregivers are going through and how to better understand the situation to relate to quality care.

CriteriaArticle 1 “PATIENT-CENTERED CARE AND TURNOVER IN HOSPICE CARE ORGANIZATIONS”Article 2 “hospice staff members prepare family caregivers”
PopulationIt involves a total of 40 staff members that have provided written consent for participation, and also provided demographic data forms.
The 19 hospice clinicians were researched who have provided care in the home setting from two hospice agencies within the US.

InterventionThe intervention was the (1) the content related to the preparatory information, (2) having strategies and timing related to the preparation along with the preparation and (3) the preparation of the families (Hickish, 2019).The intervention involves a reduction burden and distress.  The importance of competence and confidence. 
ComparisonThe journal is focused on the gap between family needs along with the current practice which would involve the development of effective preparatory interventions.The journal is focused on the caregiver and understand the reduction on the burden and disease.
OutcomeThe outcome is (1) symptoms and related to the signs of the impending death, (2) The related to the signs and symptoms, (3) Determine the expect that is linked to the symptoms and expected time to death, and (4) instructions on what to do.The outcome of the article involved the strategies, advantage of the family care and how to aid on the safety issues related to all settings.

Literature review

From the literature of Davies,2018, the nurses have to ensure how to provide a family of hospice patients who can be guided, to help them prepare for the final days of life. Still, the current practices to intervene, guide and aim to prepare the families with better care can be described. To provide aid and to reduce the gap between the family needs along with the current practices, it is important to inform the development of the family's effective preparatory interventions (Kehl 2015). As per the journal of the Haverhals (2019), it the duty of the hospice clinicians is aimed at the provision of the family care, through orally discussing the content and providing the useful preparatory information. The other aims are to help them understand the strategies along with the timing of preparation, which can help to tailor to prepare the families. It has been observed, for the nurses providing services during the end of life care, have to prepare families and provide optimum care during the hospice. Not only the nurse's roles are to guide the family caregivers but they have to ensure, they can prepare and provide caregiving to aid during the patient's death or during the end of the life routine care. The purpose remains to provide positive outcomes and aid in helping the perceived competence along with meeting an informational needs met, along with family satisfactionIt is important to understand how there can be a vital higher level of hope that can help to prepare (Kirby, 2018).  As per the Hickish (2019), the purpose is to provide a supporting system that can help to aid on the preparedness linked with the caregiver in order to overcome the fear, help in dealing with the anxiety, and provide a course of the anger, proper fatigue care and help the caregiver and the patient to understand the feeling of adjustment or any helplessness feeling. The toughest role is to comfort the patient and the family for the lack of confidence in their caregiving abilities and depression

Search Strategies 

For hospice care, the search strategy involves extensive research over the journals, magazines, newspapers and includes the research databases that aimed to provide open-access journals along with the arXiv e-print service. It included the various inclusion and exclusion depending on the search strategy. It required to have access to the open journal articles,  required to access the highly qualified review peer-reviewed journals and provides a piece of guided information. The articles were accessed from the Allied Health Literature (CINAHL), researched from the Pub Med along with the British Nursing Index (BNI) needed to collect secondary journals. 

Search term used

Terms used Reasons 
Hospice CareHospice patients should be provided proper care by the nurses and the involvement of the family, caregivers play a vital role to prepare and timely aid in. 
Patient and family members during the end of the care lifeHospice care requires patience and persistence to care for the patient and provide support to the family.

Table 1: Search term used

(Source: Created by the researcher)

Inclusion and exclusion criteria

The inclusion criteria

  • Publications of the journals taken after 2015
  • Includes an extensive electronic database

Exclusion criteria

  • Any journals or publications before 2015 
  • Journals from limited paid resources or the electronic database

Evidence-based practice

During the hospice care, the aim is to provide most of the patients and their families to provide comfort care and support. It helps the nurses to take care of the families, help them prepare, guide them and ensure to provide a support system to the end of the life patients. Evidence-based practices have shown that the caregivers act as the  "secondary patients," that require a need of protection and guidance, help them to get proper health and another factor shows how the family caregivers should be unpaid providers who need to be prepared to become competent and help in safely volunteering workers required to protect the family life system.


To conclude, as the nurse, the main purpose is to provide better hospice care for the critical patients, but it is also important to provide a support system to the family or the caregiver. If the caregiver or the family members, lose interest or do not show a keen involvement, then the intervention strategy such an accessing the situation, understanding, diagnosing and providing care to such members is also required. As  a nurse, it is duty to comfort the family and the patient during the criticality of the moment.