TY - JOUR
T1 - A quality improvement project to identify patients with advanced heart failure for potential palliative care referral in telemetry and cardiac intensive care units
AU - Camal-Sanchez, Carlos A.
AU - Simpson, Terri
AU - Curtis, J. Randall
AU - Owens, Darrell
AU - Burr, Robert L.
AU - Shannon, Sarah E.
N1 - Publisher Copyright:
© Springer Publishing Company.
PY - 2017
Y1 - 2017
N2 - Background: Although national guidelines recommend timely initiation of palliative care for hospitalized patients with advanced heart failure (AHF), providers may not recognize which patients who have heart failure are most in need of consultation. Measures: A tool was developed and pilot-tested to screen patients admitted to a cardiology inpatient service with a left ventricular ejection fraction (LVEF) of 50% or less for potential triggers signifying palliative care needs in the telemetry or cardiac intensive care unit (CICU). Intervention: The tool was completed during cardiology rounds. Outcomes: Of the 21 patients evaluated, the median LVEF was lower in the telemetry group (22%) than in the CICU group (28%). Trigger patients in the telemetry unit were less adherent to medical management (χ2 = 6.034, p = .014) and had greater psychosocial and spiritual needs (χ2 = 3.956, p = .047) than those in the CICU. Conclusion: We describe a feasible palliative care screening tool for patients with AHF hospitalized in a telemetry unit or CICU that may identify opportunities for early palliative care referrals. Additional study is needed to determine whether this tool can be used to improve patient care or patient outcomes.
AB - Background: Although national guidelines recommend timely initiation of palliative care for hospitalized patients with advanced heart failure (AHF), providers may not recognize which patients who have heart failure are most in need of consultation. Measures: A tool was developed and pilot-tested to screen patients admitted to a cardiology inpatient service with a left ventricular ejection fraction (LVEF) of 50% or less for potential triggers signifying palliative care needs in the telemetry or cardiac intensive care unit (CICU). Intervention: The tool was completed during cardiology rounds. Outcomes: Of the 21 patients evaluated, the median LVEF was lower in the telemetry group (22%) than in the CICU group (28%). Trigger patients in the telemetry unit were less adherent to medical management (χ2 = 6.034, p = .014) and had greater psychosocial and spiritual needs (χ2 = 3.956, p = .047) than those in the CICU. Conclusion: We describe a feasible palliative care screening tool for patients with AHF hospitalized in a telemetry unit or CICU that may identify opportunities for early palliative care referrals. Additional study is needed to determine whether this tool can be used to improve patient care or patient outcomes.
KW - Advanced heart failure (AHF)
KW - Palliative care service
KW - Quality improvement (QI) project
KW - Screening tool development
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U2 - 10.1891/2380-9418.10.1.17
DO - 10.1891/2380-9418.10.1.17
M3 - Article
AN - SCOPUS:85059289150
SN - 2380-9418
VL - 10
SP - 17
EP - 23
JO - Journal of Doctoral Nursing Practice
JF - Journal of Doctoral Nursing Practice
IS - 1
ER -