Effects of a palliative care trigger assessment on patient outcomes for patients admitted in the medical intensive care unit

Purpose of Project: The purpose of the project is to evaluate the effects of a palliative care (PC) trigger assessment on patient outcomes in the intensive care unit (ICU). The first aim is to address the late or absent use of PC services through a trigger assessment. The secondary aim is to increase comfort of nurses regarding PC matters, such as identification of need, assessment of patients, and discussion of PC. Methodology: Retrospective and prospective chart reviews were used to study the effects of a trigger assessment on length of stay, time to PC intervention, and resuscitation status. Additionally, pre and post intervention surveys were used to study the effects of a trigger assessment on nurse comfort levels. Participants assigned scores based on diagnoses, situational modifiers, and a surprise question. Results: 28 ICU nurses and 173 (100 at retrospective and 73 prospective) chart reviews were included in the study. Results found a 0.5 day increase to ICU length of stay compared to the usual care group. Overall, it improved on the other measured outcomes such as time to PC intervention, conversion of code status, and nurse comfort levels. It also found that code status changes occurred more frequently and quicker than in the baseline group. Implications for Practice: The project, if adopted as usual practice, could improve on increasing PC services use and preventing aggressive expensive care at the end-of-life. Additionally, the project can improve on nurse involvement in patient’s PC matters.DNPIncludes bibliographical reference