Effectiveness of a Diagnosis Trigger List on Increasing the Integration of Palliative Care in the Neonatal Intensive Care Unit.

BACKGROUND

Palliative care is underutilized in the neonatal intensive care unit (NICU). Many patients who qualify for palliative care in the NICU are not being referred.

PURPOSE: The project's purpose was to promote the integration of palliative care in the NICU by increasing the number of palliative care consultations through a diagnosis trigger list.

METHODS

The project director conducted a literature review and created and implemented a facility-specific diagnosis trigger list and educational module. Retrospective chart reviews were conducted from June 2023 through August 2023 to gather baseline data and from June 2024 through August 2024 to assess the project's impact. The Neonatal Palliative Care Questionnaire for Nurses (NPCQN) and the Neonatal Palliative Care Attitude Scale (NiPCAS) were administered to neonatal nurse practitioners at the facility by pre- and post-tests before and after receiving the module.

RESULTS

The percentage of palliative care consultations placed improved from 4% to 13%. The NPCQN showed statistically significant improvement in knowledge with a P  < .001. The NiPCAS showed statistically significant improvement in attitude concerning 2 of 26 questions, with values of P = .016 and P = .047.

IMPLICATIONS FOR PRACTICE AND RESEARCH: The implementation of a neonatal palliative care trigger list can increase the number of consultations placed. A palliative care trigger list can be generalized to other populations.