Collaborating with palliative care teams to provide end of life care for patients with heart failure: An integrative review

Advanced heart failure (HF) can be difficult for nurse practitioners (NPs) to manage in primary care due to the unpredictable nature of the condition. Further, barriers that patients with HF experience in regards to receiving end of life (EOL) care hinder NP collaboration with palliative care teams. The goal of the project is to answer: How can NPs working in a primary care setting collaborate with palliative care teams to provide patients who have HF with EOL care? A literature search was conducted using the Cumulative Index of Nursing and Allied Health, PubMed Medline, PsychInfo, Social Work Abstracts and the National Guideline Clearinghouse electronic databases. Evidence was also gathered using backward and forward reference searching, and highly relevant grey literature from the BC Heart Failure Network. The Canadian Interprofessional Health Collaborative (CIHC) framework was used to describe the theoretical underpinnings of this paper by outlining the factors involved to achieve interprofessional collaboration. There were 33 articles retrieved during the literature search to inform how NPs can collaborate with palliative care teams for patients with HF at EOL. There were no articles that answered the research question directly. Instead, barriers and issues for patients with HF receiving EOL care were identified in the findings. Nurse practitioners can collaborate with palliative care teams by addressing the barriers to EOL care for patients with HF that relates to communication, leadership, role clarification, team functioning, and conflict resolution. Nurse practitioners should be encouraged to collaborate with palliative care teams to improve accessibility to palliative care for patients with HF at EOL. Future research is needed to directly inform how collaboration can occur with palliative teams to provide patients who have HF with EOL care.