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Palliative care reduces caregiver burden, alleviates patient symptoms, and supports treatment decision-making. However, despite these benefits, there is limited evidence on the effectiveness of palliative care interventions for caregivers of individuals with advanced dementia.
To integrate and analyze data on the effectiveness of palliative care interventions in improving caregiver outcomes in order to ensure that both patients and caregivers receive the support necessary for optimal care experiences, quality of life management, and advanced care planning.
A systematic search was conducted of six databases to identify relevant studies published from database inception to 12 December 2024. Randomized controlled trials (RCTs) investigating palliative care interventions for caregivers of people with advanced dementia were included. Version 2 of the Cochrane Risk of Bias tool was used to assess the risk of bias in the methodology of each study. Standardized mean differences (SMDs) between each intervention and control group were calculated. A random-effects DerSimonian and Laird model was applied to generate pooled SMD estimates for each outcome and assess its heterogeneity. A leave-one-out sensitivity analysis was performed to ensure the stability of the pooled effect sizes.
Eight RCTs were included in the final analysis. Palliative care interventions appeared to reduce conflict in decision-making among caregivers of people with advanced dementia.
Palliative care interventions were successful in reducing conflict in decision-making of caregivers of people with advanced dementia. However, the modality's effects on caregiver satisfaction and caregiver distress need further investigation.
Future palliative care interventions for caregivers of advanced dementia patients should focus on developing the contents of palliative care materials based on evidence-based evaluations and explore strategies to improve engagement between patients, caregivers, and healthcare professionals.
The National Association of Epilepsy Centers (NAEC) published guidelines on caring for patients admitted to an in-patient epilepsy monitoring unit (EMU) in 1997. These guidelines serve as the foundation for nursing practices in this specialized field. However, there is a significant variation in nursing knowledge and confidence in caring for this patient population. This highlights the need for a standardized epilepsy education program for bedside nurses in these units, which is currently lacking.
This initiative aimed to determine the best evidence-based strategies for improving nurse knowledge and confidence in caring for inpatients in the EMU. The evidence-based practice initiative used the seven step process, a systematic approach to implementing evidence-based practice in healthcare. It involves asking a clinical question, searching for the best evidence, critically appraising the evidence, integrating the evidence with clinical expertise and patient values, and evaluating the outcomes.
After completing the first three steps of the process, it was recommended that an educational program be developed. This program included modules on understanding epilepsy, recognizing different seizure types, managing seizures in an inpatient setting, and ensuring patient safety during video-electroencephalography (VEEG).
This initiative showed a significant improvement in nurses' knowledge and confidence in caring for patients admitted to EMU. Notably, the administration of anti-seizure medications (ASMs) became more consistent, and the response to different seizure types was more uniform.
Standardized educational programs for patients admitted to an EMU are needed. The evidence-based education program developed at a free-standing Midwest pediatric hospital may be helpful for nurses in other pediatric EMUs.
Standardized education improves nurse knowledge and confidence, but access and consistency across shifts remain challenges. A structured, evidence-based module series tailored to EMU care enhances nurse preparedness and promotes safer, more consistent patient care. Ongoing education and leadership support are essential to sustain these improvements.
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