Date on Paper

7-2020

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Robertson, Sara

Committee Member

Malone, Angie

Author's Keywords

palliative care; intensive care unit; evidence-based screening tool; nursing self-efficacy; palliative care knowledge

Abstract

BACKGROUND: Internal and external evidence demonstrates a poor understanding of the definition and scope of palliative care for ICU patients by nurses. Palliative care and hospice care are often viewed as mutually exclusive rather than complimentary. This knowledge gap causes delayed palliative care consultation for ICU patients which has been shown to increase length of stay and cost of care while decreasing patient/family satisfaction. SETTING: The project took in a 36-bed Intensive Care-Open Heart Unit (ICU-OHU) in an urban hospital in the Midwest United States. PURPOSE: The purpose of the quality improvement project was to address misconceptions regarding palliative care in the ICU-OHU and increase the self-efficacy of nurses to implement a referral plan based on evidence-based referral criteria for patients who could benefit from palliative care. PROCEDURES: Nurses working on the unit participated in a brief education session regarding palliative care knowledge fundamentals and palliative care referral criteria. Following the staff meeting, a 1-month pilot period took place during which nurses were instructed to screen every patient admitted to the ICU using the presented referral criteria. Positive screens were documented for data analysis and providers were alerted. MEASURES: Outcomes measured in this project were nursing knowledge of palliative care and nursing self-efficacy in palliative care delivery, measured by the Palliative Care Quiz for Nursing (PCQN) (Ross et al, 1996) and the Self-Efficacy in Palliative Care Scale (SEPC) (Mason & Ellershaw, 2004) respectively.

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