Examination of a Palliative Care Screening Tool in Intensive Care Unit Patients

Lapp, Elizabeth Anne; Iverson, Lindsay

doi:10.1097/njh.0000000000000202

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Another pilot project at a community hospital focusing on patients with chronic obstructive pulmonary disease noted a 36% increase in appropriate referrals through the use of a screening tool 3 . Another project that occurred in the ICU at an academic medical center noted that 80.1% of patients who met the criteria on the screening tool were not referred to palliative care 26 . It is also important to note that in a national survey of 53 palliative care programs that standardized referral criteria, increased palliative team workload and inappropriate consults were noted as disadvantages and potential burdens on the palliative providers 27 …”

Section: Discussionmentioning

confidence: 99%

“…3 Another project that occurred in the ICU at an academic medical center noted that 80.1% of patients who met the criteria on the screening tool were not referred to palliative care. 26 It is also important to note that in a national survey of 53 palliative care programs that standardized referral criteria, increased palliative team workload and inappropriate consults were noted as disadvantages and potential burdens on the palliative providers. 27 The pattern of referring services appeared to change in this project with the implementation of the screening process and alert with a shift in the number of referrals from different medical teams and services.…”

Section: Discussionmentioning

confidence: 99%

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Development and Implementation of a Real-Time Inpatient Palliative Care Screening Process to Promote Earlier Palliative Care Referrals

Haranis

Lampkin

Roche-Green

et al. 2023

J Hosp Palliat Nurs

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Despite the previous development of criteria for palliative screening tools, there remains a lack of validated and practical screening processes for the general hospitalized patient population for everyday clinical use. This quality improvement project's aim was to implement a practical institution-based adult inpatient palliative care screening tool embedded into the electronic medical record with an automated alert process to assist in identifying patients earlier within hospital admission. The project used a preimplementation and postimplementation design and followed the Plan-Do-Study-Act process to measure the effectiveness of the tool and alert process in decreasing time from admission to palliative care referral and impact on referring patterns. During the project period, 1851 palliative care referrals were completed, and minimal difference (0.6%) was noted in the average time from admission to referral preimplementation and postimplementation (P = .939). There was a 3.7% increase in referrals postimplementation and a shift in referring service patterns (P = .321). Although the expected outcome of earlier palliative referrals during admissions was not met, the development and implementation of the tool and alert process is a step toward the creation of a standard practical tool for the general hospitalized patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development and Implementation of a Real-Time Inpatient Palliative Care Screening Process to Promote Earlier Palliative Care Referrals

Haranis

Lampkin

Roche-Green

et al. 2023

J Hosp Palliat Nurs

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“…The goal of this project was to identify unmet palliative care needs of those patients admitted to the ICU and who subsequently died in the ICU. The CAPC ICU screening tool was utilized to categorize historical data of those patients who met criteria of need for palliative care (Lapp & Iverson, 2015). This project incorporated historical data of current practice obtained from a 3 month electronic medical health record (EHR) retrieval on diagnosis, LOS, course of events, initial physician conversation regarding the EOL, if and when families make EOL decisions, time to decision from initial physician conversation of EOL, and final disposition, from the previous year of 2017.…”

Section: Project Designmentioning

confidence: 99%

“…When a life altering event occurs or if there is a sudden or drastic decline in an acute or chronic illness, these patients will be admitted or transferred to an intensive care unit (ICU). Of these patients 20% will die, most often due to advanced age or progression of an acute or chronic illness [1,2]. Additionally, those patients with chronic health conditions are living longer than ever, due to the advances in medicine.…”

Section: Introductionmentioning

confidence: 99%

The Use of a Palliative Care Screening Tool in the Intensive Care Unit

Hatchell

2020

ACRCI

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Background: Patients with an abrupt life altering event or chronic illness are admitted to the intensive care unit (ICU) and frequently are at the end of life (EOL). Most often, these patients have not established or discussed their quality of life wishes at the EOL with their families or healthcare providers. This creates uncertainty and stress for the patients' loved ones, and ethical issues of patient pain and suffering while enduring futile lifesaving interventions.

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Palliative care screening tools and patient outcomes: a systematic review

Zhang,

Zhao,

Peng

2024

BMJ Support Palliat Care

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BackgroundPalliative care (PC) refers to providing patients with physical, psychological, mental, and other care and humanistic care services in a multidisciplinary collaborative mode with end-of-stage patients and family members as the centre. The PC screening tool (PCST) was developed to identify individuals who may benefit from PC services and is widely assumed to improve patient outcomes.ObjectivesThe purpose is to understand which specific PCST has been applied to clinical patients and to analyse and summarise the impact of using these tools on patient outcomes.MethodsA systematic review of articles published on PCST was performed in PubMed, Web of Science, CINAHL and MEDLINE in January 2024. All original research articles on PCST fulfilling the following eligibility criteria were included (1) utilisation and evaluation of tools was the primary objective and (2) at least one patient outcome was reported.ResultsA total of 22 studies were included, 12 studies used a prospective study, 4 studies used a non-RCT and 6 studies used an RCT. The studies were heterogeneous regarding study characteristics, especially patient outcomes. In total, 24 different patient outcomes were measured, of which 16 outcomes measured in 12 studies significantly improved.ConclusionsWe found that the majority of included studies reported that implementing PCST can improve patient outcomes to some extent, especially when used to improve in reducing hospitalisation time and patient readmission rate. However, there is a lack of high-quality research on this widely used screening tool.

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Examination of a Palliative Care Screening Tool in Intensive Care Unit Patients

Cited by 7 publications

References 21 publications

Development and Implementation of a Real-Time Inpatient Palliative Care Screening Process to Promote Earlier Palliative Care Referrals

Development and Implementation of a Real-Time Inpatient Palliative Care Screening Process to Promote Earlier Palliative Care Referrals

The Use of a Palliative Care Screening Tool in the Intensive Care Unit

Palliative care screening tools and patient outcomes: a systematic review

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