Unmet Palliative Care Needs in the Medical Intensive Care Unit
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Background: The implementation of high-quality palliative care in the intensive care unit (ICU) varies greatly. A lack of palliative care in the ICU has been shown to have a negative impact on patients, families, staff, hospital resources, and healthcare costs. Currently, there is no policy or guideline in place for palliative care integration within the ICUs at this medical center. Objective: The objective of this project is to evaluate if the implementation of an Advanced Practice Provider (APP)-driven standardized assessment tool to help identify patients with unmet palliative care needs impacts specialty palliative consults in the medical intensive care unit (MICU). Design: An unmet palliative care needs assessment tool was added to a daily ICU rounding checklist and the MICU APPs were asked to incorporate this tool within their daily practice. Prior to implementation, MICU APPs were provided with education on palliative care and available resources. Setting: Project implementation took place in a twenty-four bed MICU at a large academic medical center located in the Midwest. Results: Baseline data was compared to implementation data which revealed that the assessment tool had no impact on the number of palliative consults, hospice referrals, or the mortality index for the four-week implementation period in the MICU. APP responses to a post-implementation survey, which had a 50% completion rate, provided helpful feedback. Conclusion: Overall, this project provided potential future implications for improving palliative care within this such as the implementation of a palliative care tool within services outside of the MICU; focusing on the identification and management of cancer related symptoms in the MICU; and using a standardized tool to promote involving palliative services earlier in a patient's ICU or hospital stay.
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