DescriptionPurpose of Project: Palliative care screening in the ICU setting has been endorsed by the Center to Advance Palliative Care and by the National Institutes of Health. This screening criteria when applied to other hospitals’ ICU settings have shown to be impactful for patient outcomes including length of stay and cost control. This quality improvement project had aimed to adapt the CAPC ICU palliative care screening criteria to a Neuro-ICU in a hospital in northern New Jersey to improve patient outcomes.
Methodology: This project was completed over a 4-month period in the Summer and Fall of 2020, with a pre- and post-screening period for palliative care lasting each 2 months. The pre-screened group (Group A) contained 64 patients, while the post-screened group (Group B) contained 70 patients. Statistical analysis was used to determine if patient outcomes defined as length of stay, family meetings, palliative consults, and DNR status orders were impacted after palliative care screening implementation.
Results: The results showed that after palliative care screening in this Neuro-ICU, family meetings increased by twice as much (p=0.17), and that palliative consults and DNR statuses slightly increased (p=0.6), but without statistical significance. Further analysis of the patients by diagnosis resulted in that Intraparenchymal patients had a statistically significant increase in family meetings after palliative care screening (p=0.05), but no other statistically significant conclusions were made by breakdown of diagnosis. Neuro-ICU mean length of stay, however, unexpectedly slightly increased after palliative care screening (p=0.6), without statistical significance.
Implications for Practice: Family meetings tends to improve patient/family communication with the healthcare staff and allows patient/families to feel more satisfied with the care. Palliative consults are associated with cost saving measures in the ICU as well as a reduction in length of stay. To conclude, more projects and research are needed to determine effective palliative care screening criteria and its effectiveness in ICU settings and more inpatient areas.