Outcomes Associated With a Nurse-Driven Palliative Care Screening Tool in the Intensive Care Unit

专业 医学 缓和医疗 重症监护室 介绍 危重护理 重症监护 预先护理计划 梅德林 护理部 家庭医学 急诊医学 重症监护医学 医疗保健 经济增长 经济 法学 政治学
作者
Kim Martz,Jenny Alderden,Rick Bassett,Dawn Swick
出处
期刊:Critical Care Nurse [AACN Publishing]
卷期号:40 (3): 23-29 被引量:31
标识
DOI:10.4037/ccn2020702
摘要

Background Access to specialty palliative care delivery in the intensive care unit is inconsistent across institutions. The intensive care unit at the study institution uses a screening tool to identify patients likely to benefit from specialty palliative care, yet little is known about outcomes associated with the use of screening tools. Objective To identify outcomes associated with specialty palliative care referral among patients with critical illness. Methods Records of 112 patients with positive results on palliative care screening were retrospectively reviewed to compare outcomes between patients who received a specialty palliative care consult and those who did not. Primary outcome measures were length of stay, discharge disposition, and escalation of care. Results Sixty-five patients (58%) did not receive a palliative care consult. No significant differences were found in length of hospital or intensive care unit stay. Most patients who experienced mechanical ventilation did not receive a palliative care consultation (χ2 = 5.14, P = .02). Patients who were discharged to home were also less likely to receive a consult (χ2 = 4.1, P = .04), whereas patients who were discharged to hospice were more likely to receive a consult (χ2 = 19.39, P < .001). Conclusions Unmet needs exist for specialty palliative care. Understanding the methods of identifying patients for specialty palliative care and providing them with such care is critically important. Future research is needed to elucidate the factors providers use in their decisions to order or defer specialty palliative care consultation.

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