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Implementing a palliative care screening tool in the emergency department
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Ciani, Amanda. Implementing a palliative care screening tool in the emergency department. Retrieved from https://doi.org/doi:10.7282/t3-d1er-fd09

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TitleImplementing a palliative care screening tool in the emergency department
NameCiani, Amanda (author); Kameinski, Mary (chair); Clyne, Timothy (member); Cruz, Geraldine (member); Rutgers University; RBHS School of Nursing
Date Created2023
Other Date2023-01 (degree)
SubjectNursing, Emergency medicine, Palliative care, Screening tool
Extent67 pages : illustrations
DescriptionPurpose: Palliative care (PC) is a service that is often underutilized for patients with advanced chronic illnesses. Currently there is no specific policy for referrals for PC from the emergency department (ED). By implementing a screening tool for PC in the ED, these patients can be identified and referred. Implementation of an evidence-based PC screening tool will improve identification and referral of services to these patients. The purpose of this quality improvement project is to accurately screen for patients in the ED who may benefit from PC services.
Methodology: The P-CaRES screening tool was implemented in a 46- bed ED in an urban area of central New Jersey. All ED providers were educated on use of the screening tool. Patients over the age of 65 that were admitted to the ED were screened for unmet PC needs using the P-CaRES screening tool. Chart reviews were conducted to determine if screening, referrals, and consults for PC were affected by the implementation of the P-CaRES screening tool in the ED.
Results: In total 1208 patients over the age of 65 were seen in the ED over a two- month period and 33.4% were screened using the P-CaRES screening tool. During this time 22.1% screened positive for unmet PC needs and 27% of those screening positive were admitted to the hospital. Referrals for PC consultation were made for 92.3% of patients admitted to the hospital that screened positive for unmet PC needs. A total of 7.4% of patients admitted to the ED during the two-month period received a PC consult. A chi-squared statistical test for analysis was run to compare referral and consultation rates in the pre and post implementation periods. Results of the chi-squared test for referral rates showed a p value of 0.004 concluding there is a statistically significant difference in referral rates before and after the implementation of the P-CaRES screening tool with an increase in referrals after implementation. The chi- squared test for consult rates showed a p value of 0.592 concluding there was not a statistically significant difference in consultations before and after implementation.
Implications for Practice: Screening for PC in the ED can increase referral rates for PC in a timely manner. Screening patients for PC in the ED can reduce symptoms, improve outcomes for patients and their families, improve quality of life and decrease resource utilization.
NoteD.N.P.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-d1er-fd09
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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