Implementation and evaluation of a network-based pilot program to improve palliative care in the in

PUBMED ID:

22045370

PubMed - indexed for MEDLINE

Authors:

Penrod JD, Luhrs CA, Livote EE, Cortez TB, Kwak J

Institution:

James J. Peters VA Medical Center, Bronx, New York, USA.

Title:

Implementation and evaluation of a network-based pilot program to improve palliative care in the intensive care unit

Source

J Pain Symptom Manage.2011 Nov;42(5):668-71

Abstract

 

Background:

Intensive care unit (ICU) care could be improved by implementation of time-triggered evidence-based interventions including identification of a patient/family medical decision maker, the patient's advance directive status, and cardiopulmonary resuscitation preferences by Day 1; offer of social work and spiritual support by Day 3; and a family meeting establishing goals of care by Day 5. We implemented a program to improve care for ICU patients in five Department of Veterans Affairs' ICUs.

Measures:

We measured the percent of ICU patients with lengths of stay of five or more days that received the care processes by the appropriate day.

Intervention:

Critical care and palliative care providers trained ICU nurse teams to improve care through auditing, performance feedback, improvement tools, education, and monthly team meetings.

Outcomes:

Pre- and postintervention care were compared. Offering social work and spiritual support, identification of the medical decision maker, and documentation of family meetings significantly improved. CONCLUSIONS/LESSONS LEARNED: ICU nurse teams can be engaged to improve care under the aegis of a collaborative quality improvement project.

 

Published by Elsevier Inc.