Abstract
Background: Current health care trends demonstrate that there are an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness, rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals.|Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit.|Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the age of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session for staff nurses on the benefits of palliative care was conducted by the researcher and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three-month piloting of the tool.|Results: During the initial retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. During the intervention period, 22 palliative care screening tools were completed. Of those, 15 of the patients scored a 7 or higher on the tool, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame.|Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care.|Recommendations: It is recommended that this screening tool be used to help identify the patients of who would benefit from a palliative care consultation, and that nurses would be able to initiate a palliative care consultation.|Keywords: palliative care, screening, early, palliative care consult