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Implementation of a palliative care screening tool in the surgical trauma ICU
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Delgrosso, Sarah. Implementation of a palliative care screening tool in the surgical trauma ICU. Retrieved from https://doi.org/doi:10.7282/t3-nxsa-y141

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TitleImplementation of a palliative care screening tool in the surgical trauma ICU
NameDelgrosso, Sarah (author); Barberio, Judith (chair); Evans, Tracylain (member); Rutgers University; RBHS School of Nursing
Date Created2022
Other Date2022-05 (degree)
SubjectNursing, Medicine, Critical care, Goals of care, Palliative care screening, Quality improvement, Surgical intensive care, Trauma
Extent64 pages
DescriptionPurpose of Project: Trauma creates a unique barrier to establishing patient goals of care, with gaps in recognizing the risk for unmet palliative care needs. The American College of Surgeons (ACS) released palliative care practice guidelines that includes screening for needs within 24 hours of hospital admission and establishing goals of care conversations within 72 hours. This project aimed to improve the frequency in documented goals of care conversations by identifying those patients at risk through the implementation of the palliative care screening tool on all trauma patients admitted to the Surgical-Trauma ICU (STICU).
Methodology: This quality improvement project used a retrospective and prospective chart review, with a pre/post design to measure if the implementation of the screening tool would encourage earlier goals of care discussions in the trauma population. Clinical staff was also anonymously surveyed on evaluation of the screening tool after implementation.
Results: A sample of 91 (N = 91) patient records were reviewed with preintervention patients (Group A; n = 41) compared to post intervention patients (Group B; n = 50). There were no significant differences in demographics on admission, ICU length of stay, and days on mechanical ventilation between the two groups. No statistical significance was found between the number of goals of care conversations held between the two groups. However, the data suggests a clinically significant increase in the number of goals of care conversations held on those admitted with a Glasgow Coma Scale (GCS) less than 8 in the post intervention group compared to pre intervention. Responses of the clinical staff survey suggest an overall positive evaluation of the screening tool.
Implications: Screening of trauma patients on admission identifies those at risk for having unmet palliative care needs throughout hospitalization. Further implementation and use of this intervention has potential to increase the frequency of family meetings to address goals of care conversations, increase communication amongst the healthcare team, and decrease burdensome ICU days. The development of a practice guideline in the clinical setting for the standardized use of a screening tool to identify palliative care needs is needed to reinforce practice.
NoteD.N.P.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-nxsa-y141
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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