Dr. Teresa White is a Nursing Professional Development Specialist who is passionate about conducting research to help improve the outcomes of the patients in the acute care setting. She has done several projects that have resulted in a direct improvement on quality outcomes and hopes to continue to find ways to empower nurses to have this lasting impact in health care.
Background: Palliative care improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering. It is often confused by health care professionals with hospice which is a facility or program designed to provide a caring environment for meeting the physical and emotional needs of the terminally ill.
Co-morbidities have consistently contributed to 7 and 30-day readmission rates being above the benchmark and nursing has been attempting to identify solutions to address this issue. This is a population of individuals who would quality for palliative care services, yet are never offered palliative care services. Nurses are the caregivers at the bedside of the patient who can help to identify those individuals needing palliative care services in order to help prevent readmissions and provide for better symptom management in these individuals.
Sample/Methods: A convenience sample was used. Data was analyzed doing a comparison of the 7 & 30 day readmission rates before and after the specified timeframe.
Results: Upon completion of the first 90 days of data collection, a comparison of data was done to determine if the palliative care screening tool on admission was having an impact. The 30 day overall readmission rate did not show any significant improvement. In evaluation of the 7 day readmission data the only disease process that had any change was that of heart failure. Data was only available from QRD for the first two months which showed a positive decrease, though it cannot be excluded that this is due to normal variation until the remainder of the data is complete. It could be concluded that if heart failure is the only disease process that had a change that it was due to the two units selected for the initial research were both the primary cardiac units at the hospital where the research is being done.
Conclusions and Implications for Practice: After completion of the initial parts of this research, it is determined that a longer timeframe is needed to continue to collect the readmission rates in order to conclude if conducting a palliative care screening on admission to an acute care setting can have an impact on readmission rates over an extended period of time. The next steps will be to expand the palliative care screening tool to all adult inpatient units so that a larger population of patients can be included in the data. Having a larger population of patients be included may impact the readmission rates more globally than just the use of the tool on the two specified units.
Nurses who were able to use the palliative care screening tool felt more empowered to get the services needed for their patients because they had the ability to initialize the consult nurse-to-nurse verses having to obtain a physician order to have this process started. There was also an increase in palliative care consults by 15.1% when compared to the previous year at the same time.