Dimensions of critical care nursing : DCCN · 2026
Improving Timeliness of Palliative Care Referrals Within the ICU: A Quality Improvement Project.
СтатьяНазвание и аннотация: Перевод в очереди
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Fiore Stephanie, O'Donovan Simone, Milner Kerry A
Аннотация
BACKGROUND: The ICU often provides aggressive treatments that may be futile for critically ill patients. Palliative care (PC) aims to enhance the quality of life for patients with life-threatening illnesses. Despite recommendations for early PC consultations, delays remain prevalent worldwide.
OBJECTIVE: This project aimed to improve the timeliness of PC referrals in a New York City hospital ICU through the implementation of a nurse-driven PC screening tool.
METHODS: Using the Model for Improvement, this quality improvement project was conducted over 7 months, including a 4-month baseline phase and a 3-month implementation phase. ICU nurses used a PC screening tool to evaluate patients within 48 hours of admission. The project aimed to increase PC screenings to 75% and ensure PC referrals within 48 hours.
RESULTS: The implementation phase saw a significant increase in PC screenings, with compliance reaching 90.9% after process adjustments. The average time to PC referral decreased from 8.9 days pre-intervention to <2 days in the 3-month implementation phase. Of the patients receiving PC consultations, 46.6% had do not resuscitate and/or intubate status established, and 20% transitioned to hospice or comfort care.
CONCLUSIONS: The nurse-driven PC screening tool effectively improved the timeliness of PC referrals, demonstrating the importance of standardized screening processes in the ICU.
OBJECTIVE: This project aimed to improve the timeliness of PC referrals in a New York City hospital ICU through the implementation of a nurse-driven PC screening tool.
METHODS: Using the Model for Improvement, this quality improvement project was conducted over 7 months, including a 4-month baseline phase and a 3-month implementation phase. ICU nurses used a PC screening tool to evaluate patients within 48 hours of admission. The project aimed to increase PC screenings to 75% and ensure PC referrals within 48 hours.
RESULTS: The implementation phase saw a significant increase in PC screenings, with compliance reaching 90.9% after process adjustments. The average time to PC referral decreased from 8.9 days pre-intervention to <2 days in the 3-month implementation phase. Of the patients receiving PC consultations, 46.6% had do not resuscitate and/or intubate status established, and 20% transitioned to hospice or comfort care.
CONCLUSIONS: The nurse-driven PC screening tool effectively improved the timeliness of PC referrals, demonstrating the importance of standardized screening processes in the ICU.