Increasing interdisciplinary discussion on end of life and POLST form completion in the medical intensive care unit

Purpose of Project: End of life conversations are extremely important for providers to have with their patients. In the medical intensive care unit, life-saving therapies such as artificial ventilation, cardiopulmonary resuscitation, and artificial nutrition/hydration are not out of the question. Therefore, knowing the wishes of patients is vitally important because these therapies can many times prolong death and suffering. Methodology: This quality improvement project used a retrospective and prospective chart review, along with a pre and post-survey with an educational intervention and introduction of Karnofsky Performance scale for nurses working in the MICU. Results: These findings showed higher rates of POLST form completion from 1% to 4% and an increase in an interdisciplinary discussion on EOL conversation from 12.1% to 64% which shows that the education influenced nurses. Although there was a significant increase in documentation of EOL conversations, more time is needed to see a much more significant rise in POLST form completion Implications for Practice: Health care providers need to maintain ongoing communication regarding the patient's needs and preferences to provide holistic care. Ensuring that patients are being screened upon admission makes sure that the EOL conversation and goals of care are discussed in a timely manner. Having a policy in place will enforce this screening process. Documentation in the medical record regarding these preferences will be easy to track and can easily be found if an emergent situation arises.DNPIncludes bibliographical reference