Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Melanie Hardin-Pierce

Clinical Mentor

Dr. Lewis Perkins

Committee Member

Dr. Sheila Melander

Abstract

PURPOSE: The purpose of this study is to evaluate the use of a screening protocol for identifying patients with unmet palliative care needs, and improve access to these services in the intensive care units at Norton Hospital.

METHODS: This study was a single-site retrospective report of the impact of a palliative care screening protocol on palliative care use and quality metrics that correlated to access to palliative care services in the intensive care units at Norton Hospital. The sample consisted of 135 medical records of patients admitted during the study period, which spanned the timeframe between January 1, 2017 and April 1, 2017.

RESULTS: No differences in total charges billed or length of stay were found between patients who received palliative care services and those that did not. Patients that met screening tool criteria for palliative care services were more likely to have received a consult for palliative care services during admission, and patients that met screening tool criteria but did not receive consults were more likely to die or be discharged to home hospice than those that did not meet criteria (p = 0.000).

CONCLUSION: Implementation of a palliative care screening protocol can significantly improve identification of critically ill patients with unmet palliative care needs and increase access to palliative care services. A systematic approach to palliative care consultation maximizes the benefits of palliative care consultation, and ensures that patients with palliative care needs are identified and served.

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