Developing a Palliative Care Screening Process in the Intensive Care Unit
1 online resource (54 pages) : PDF
University of North Carolina at Charlotte
Background: Goals of care in the intensive care setting often involve futile approaches for those suffering with serious chronic illness. Among the number of chronically ill patients who die in intensive care, only a minority receive palliative care services. Early access to palliative care provides many patient centered benefits and healthcare cost savings. Experts recommend universal palliative care screening in hospitals to promote early recognition and intervention.Measures: The feasibility of implementing a palliative care screening tool was examined on an 8 bed intensive care unit at a rural hospital located in Central Piedmont North Carolina. Referral rate data was also collected. Intervention: Nurses implemented screening during a 4-week period using a standardized tool. Screening results were communicated to attending physicians. Referral rate was compared to the same 4-week period one year prior. Anecdotal comments were also collected from the staff regarding the process. Outcomes: During the project, forty patients were admitted and 62.5% were considered for screening by the staff. Eight patients were screened using the tool, and of those only 4 scores were communicated to attending physicians. Nursing staff had positive comments about the tool and recommended adding it to the admission assessment process. Referral rate did not change as compared to the same time interval one year prior. Conclusions/Lessons Learned: There were limited conclusions that could be made about feasibly based on the small sample size. It was encouraging that more than half of patients admitted were considered for screening and the screening instrument was well received by staff. More data is needed, however future projects may focus on comparing multiple tools, evaluating nurse-identified barriers, or examining physician communication processes.
CHRONIC DISEASEHOSPICEINTENSIVE CAREPALLIATIVE CARESCREENINGTRIGGERS
Whitaker-Brown, CharleneLynch, Susan
Frankhouser, CharlesHopcroft, Rosemary
Thesis (D.N.P.)--University of North Carolina at Charlotte, 2018.
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