WSU Researcher Gets Blues Grant To Study End Of Life Care
Wayne State University announced that Margaret L. Campbell, assistant professor of nursing in the Wayne State University College of Nursing, received $73,784 from the Blue Cross Blue Shield of Michigan Foundation to determine the benefit of routine oxygen administration to terminally ill patients who are near death.
Oxygen administration can be beneficial for making terminally ill patients who are experiencing shortness of breath -- known as dyspnea -- more comfortable. As patients approach death, however, changes in cognition and consciousness make it difficult to determine whether dyspnea is occurring. Applying oxygen to patients who are no longer responsive is the current standard; however, it is not clear if this practice is beneficial.
Campbell's study, which will work to shed light on the usefulness of this practice, stemmed from her own bedside experience with patients.
"Nurses are often left guessing as to how to treat patients once they can no longer communicate with us," she said. "Oxygen administration could prolong natural dying, even making patients uncomfortable -- we don't know. For these reasons, there is an urgent need to determine whether oxygen at the end of life serves a beneficial purpose or if it increases suffering."
Using an observation scale of Campbell's design, respiratory distress signs will be measured in patients as weighted, objective variables. These signs, which include rapid breathing, increased heart rate and increased use of chest and abdomen muscles, will be recorded when patients breathe room air, medical air or oxygen. Any changes in respiratory distress signs will suggest whether oxygen administration is making a difference in patients' breathing ability and general comfort level, suggesting whether the effect is positive or negative. Oxygen will not be withheld as part of the study but rather measured according to physicians' orders.
"Past studies on the benefits of oxygen administration have almost always excluded near-death patients," Campbell said. "It will be incredibly valuable to have more information indicating whether this practice is really helping patients be more comfortable at the end of their lives."
Said Ira Sturmwasser, executive director and CEO of the Blue Cross Blue Shield of Michigan Foundation: "Blue Cross Blue Shield is committed to research that will educate physicians on the best possible patient care. In determining whether oxygen administration increases patients' comfort levels or causes unnecessary distress, we will significantly increase our understanding of patient needs and, if necessary, reshape physician practices to meet those needs with the purpose of improving the quality of patient care."
More at www.research.wayne.edu.
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