Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review
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Carvajal, A., Haraldsdottir, E., Kroll, T., McCormack, B., Errasti-Ibarrondo, B. & Larkin, P. (2019) Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review. International Practice Development Journal, 9(2).
Background: Registered nurses are increasingly expected to provide person-centred end-of-life care. However, there is a gap between patients’ needs and the capacity of nurses to meet the existing recommendations on provision of this care. Identifying the relevant barriers and facilitators can inform the development of strategies to support person-centred nursing.Aim: To identify registered nurses’ perceived barriers and facilitators in terms of providing person-centred end-of-life care.Method: A scoping review was conducted according to the 2005 guidelines proposed by Arksey and O‘Malley. The databases Medline, CINAHL, PsycINFO, Cochrane, Web of Science and Embase were searched using the period 2000 to 2018. Empirical studies, literature reviews and studies focusing on the experiences of generalist nurses providing end-of-life care were included. The selected articles were independently reviewed by two researchers.Results: A total of 2,126 publications were identified, with 26 retained after applying the eligibility criteria. Four barriers to providing person-centred care were identified: knowledge of end-of-life care; communication skills; coping strategies; and teamwork. Three main facilitators were identified: knowing the person in a holistic way; nurses’ self-knowledge; and the development of a good nurse-person relationship. Organisational and managerial support also emerged to be important. These findings are reflected in the construct of McCormack and McCance’s (2017) Person-centred Practice Framework.Conclusions and implications for practice: This review provides an overview and an understanding of the key elements that influence the provision of person-centred end-of-life care by registered nurses. These barriers and facilitators point to professional competencies that could improve nurses’ ability to provide this care. This scoping review highlights registered nurses’ need for more specific education, and the elements identified could be a starting point to design an innovative educational programme for registered nurses focused on person-centred end-of-life care to improve person-centred care-related outcomes.