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The Embedment of Palliative Care Services on a Neuro-Surgical Unit (CS359)
Journal of Pain and Symptom Management ; 65(5):e569-e570, 2023.
Article in English | EMBASE | ID: covidwho-2304040
ABSTRACT

Outcomes:

1. A better understanding of the benefits of embedded palliative care into a neuro surgery unit at a large academic hospital 2. An understanding of the financial impact related to embedding a palliative care APC into the neuro surgery unit at a large academic hospital

Problem:

Palliative care needs of patients admitted to neurology ICUs are often unmet. Patients with palliative care needs identified were more likely to die in an ICU setting or be transferred to the floor with comfort measures only. These patients were noted to have a longer length of stay. Because of the known benefits of palliative care, specifically, with this vulnerable population of patients, there was a desire to increase the palliative care presence on the neuro surgical service. Intervention(s) One APC palliative care position specific to the neuro ICU team was created. Responsibilities included symptom management, family support, medical decision making, managing conflicts over care goals, and disposition planning. Outcome(s) Outcomes included involvement in interdisciplinary rounds, increased donor opportunities, and increased billing by 28% in 2021. There was a 46% increase in palliative care consults from 2020 to 2021 and an increase in percentage of DNR/DNI orders obtained during admission from 2020 to 2021. An increase in deaths during hospitalization with active palliative care consults on comfort care was noted. Statistics were collected specific to mortality, ICU LOS, diagnosis, COVID status, social work involvement, as well as spiritual care involvement. Conclusion(s) Patients are seen earlier in their hospitalization and their medical wishes are now widely known and discussed by all interdisciplinary team members. The need for the involvement of the APC in these cases has only solidified with increased exposure to the palliative care team as consults increase. Patients are benefitting from the quality care being provided that now better aligns with their personal medical goals. Implications for nursing There are many vulnerable patient populations for whom palliative care could be just as impactful;additional research should be completed to investigate further. Palliative care embedded on an ICU improves collaboration and increases exposure and understanding of the intent of palliative care.Copyright © 2023
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of Pain and Symptom Management Year: 2023 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of Pain and Symptom Management Year: 2023 Document Type: Article