Implementation of a palliative care screening tool in the intensive care unit

Purpose: The Intensive Care Unit (ICU) lacks a standardized approach to palliative care (PC) consults, so this quality improvement (QI) project evaluated if completion of a PC screening tool on admission to the ICU increased PC consults. Methodology: A QI project with a time-interrupted retrospective chart review. Patient medical records from February 2020 (n=92) and February 2021 (n=41) were reviewed and screened using the proposed PC screening tool. A sample of 85 nurses working in the ICU were given education on the proposed PC screening tool. The proposed PC screening tool was then implemented for a one-month period in February 2021. Descriptive statistics were used to evaluate the usefulness of the proposed PC screening tool and nurse compliance with PC screening tool completion. A Chi-square test was performed to determine an association between PC screening tool completion and PC consults placed on eligible patients. Results: No statistically significant association between PC screening tool completion and PC consults placed on eligible patients (p=0.096). However, there was an overall increase in the proportion of PC consults on patients who screened positive after implementation of the proposed PC screening tool (15.4% to 19%). Additionally, > 50% of eligible patients screened positive, indicating patients have unmet PC needs in the ICU. During the intervention, only 35% of eligible patient admissions had a PC screening tool completed, showing poor compliance amongst nurse participants. Implications for Practice: Further research and quality improvement projects should be completed to address the unmet PC needs of patients and to standardize the approach to PC screening and PC consults in the ICU.DNPIncludes bibliographical reference