Date of Completion of Thesis/SIP

Spring 6-29-2020

Document Type

Scholarly Inquiry Paper (SIP)

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Kimberly J Langer

Second Advisor

David Steele

Abstract

Abstract

The use of palliative care is often overlooked until the terminal phase of serious illness when life-prolonging interventions are deemed futile and death is considered imminent.

Alongside the well regarded Clinical Practice Guidelines for Quality Palliative Care (National Coalition for Hospice and Palliative Care, 2018), numerous critical care societies including the American Association of Critical-Care Nurses (Medina & Puntillo, 2006), American College of Critical Care Medicine (Davidson et al., 2008), American College of Chest Physicians (Selecky et al., 2005), American College of Surgeons (2017), and the American Thoracic Society (Lanken et al., 2007) have each published individual policies highlighting the importance Palliative Care medicine in the intensive care unit. The most recent joint policy statement from the Choosing Wisely (2014) task force comprised of the aforementioned critical care societies that addresses palliative care recommends regular engagement in conversations regarding comfort alternatives with families and patients at a high risk of death.

Based on the outcomes of a systematic literature review and review of multiple clinical policy guidelines, the recommendation is to consider a piloted evidence-based practice project that explores the timely assessment of critically ill patients with the use of a palliative care bundled approach to screening patients meeting criteria for palliative care services. Providing timely and consistent palliative care services has been found to provide several benefits including improved symptom management, increased quality of life, increased patient and family satisfaction, decreased Intensive Care Unit and hospital length of stay, a decrease in downstream hospital costs, and readmission rates (Braus et al., 2017; Ciemins, Blum, Nunley, Lasher, & Newman, 2007; Kupensky, Hileman, Emerick, & Chance, 2015; Weissman & Meier, 2011)

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