College of Nursing
Problem Statement: Dyspnea is a distressing phenomenon experienced frequently in end-of-life patients. Nurses currently rely on their own experiences and observations of other nurses to guide their assessment and treatment of dyspnea. Lack of a standardized tool may lead to inconsistencies and inadequate care.
Purpose: Determine if the implementation of the RDOS will improve the nurses’ ability and self-reported comfort levels to assess and treat respiratory distress in patients at the end of life adequately and consistently.
Methods: A pre-test and post-test design evaluated nurses’ ability and self-reported comfort levels assessing and treating respiratory distress in end-of-life patients. Nurses rated patients’ respiratory distress, determined if intervention was indicated, and reported which intervention they selected. Likert style survey questions allowed the nurses to evaluate the RDOS’s ease of use and clinical utility.
Inclusion Criteria: A convenience sample of all nurses working in the STICU at a level one trauma center during the 4-month period of the study were included.
Analysis: A t-test (p:1.57E-05) and paired t-test (p: 0.0007) determined there was a significant difference in the nurses’ ability to identify the severity of dyspnea in case studies. T-tests determined there was not a statistically significant difference (p: 1.72) in self-reported nurse comfort levels. All nurses who completed the RDOS evaluation survey (n=8) agreed that the RDOS had clinical utility and improved their assessments of dyspnea at the end of life.
Implications for Practice: The use of a standardized tool to aid in the assessment and treatment of respiratory distress in end-of-life patients may lead to more consistent treatment of dyspnea, decreased patient discomfort, and decreased nurse stress.
Integration of the Respiratory Distress Observation Scale for Patients at the End of Life
Dyspnea is a prevalent and distressing symptom experienced by patients at the end of life. As patients progress towards death, they may become cognitively impaired or lose consciousness leaving them unable to report their symptoms of dyspnea (Campbell, 2018). The use of a standardized, evidence-based tool may help guide nurses in their assessment and treatment of respiratory distress in patients at the end of life (Birkholz & Haney, 2018).
Starnes, Alexandra Mackenzie, "Integration of the Respiratory Distress Observation Scale for Patients at the End of Life" (2022). Doctor of Nursing Practice Scholarly Projects. 18.