Increasing Early Referrals to Palliative Care Through Implementation of a Standardized Screening Process

2.50
Hdl Handle:
http://hdl.handle.net/10755/164846
Category:
Abstract
Type:
Presentation
Title:
Increasing Early Referrals to Palliative Care Through Implementation of a Standardized Screening Process
Author(s):
Wineland, Elizabeth; Fisher, Kelli
Author Details:
Elizabeth Wineland, RN, MSN, OCN, Oncology Nurse Manager, Memorial Medical Center, Springfield, Illinois, email: wineland.beth@mhsil.com; Kelli Fisher, BSN, RN
Abstract:
Clinical/Evidence Based Practice: Appropriate, timely palliative care referrals allow patients and families to benefit from available resources and enhance quality care. In our 524-bed Level I Magnet Hospital, the palliative care nurse identified that often referrals are received inconsistently, late, and/or on an emergent basis. Oncology nurses possess knowledge and skills needed to screen patients appropriate for palliative care. However, in our 27-bed Oncology unit, nurses lacked a standardized, evidence-based mechanism to identify and initiate palliative care referrals, especially at the end of life. Baseline data uncovered under-utilization as well. We discovered we did not have an efficient, consistent method for alerting the care team to the potential need for palliative care screening. The purpose of this quality improvement project was to develop a screening process designed to trigger referrals earlier in hospitalization or the disease process, in order to provide the highest quality, most appropriate care for our vulnerable population. The Palliative Care Screening Instrument (PCSI; Center to Advance Palliative Care) was piloted for 60 days by the professional nursing staff. Implementation included: standardized education for the nursing staff, initiating screening using the PCSI for each patient, and identifying appropriate patients for referral if they reach the scoring threshold of three. In the 60 days prior to implementation, only 7 referrals were made. In the 60 days which constituted the pilot, all 159 patients admitted were screened, with 90 deemed appropriate for initial referral. The palliative care nurse was notified, and a brief chart review was completed on all 90 patients involving 81 different physicians, not only oncologists. Of these, 30 were referred for palliative care by the physician. The number of palliative care consultations increased more than 4-fold from the number of patients referred in the 2 months previous to the pilot period. Implementation of a palliative care screening process using a standardized tool increased the awareness of early identification for patients who might benefit from palliative care services. These changes allow Oncology nurses to facilitate by increasing communication, coordination, and collaboration of the plan of care. Research is needed to determine the impact of early referral on outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleIncreasing Early Referrals to Palliative Care Through Implementation of a Standardized Screening Processen_GB
dc.contributor.authorWineland, Elizabethen_US
dc.contributor.authorFisher, Kellien_US
dc.author.detailsElizabeth Wineland, RN, MSN, OCN, Oncology Nurse Manager, Memorial Medical Center, Springfield, Illinois, email: wineland.beth@mhsil.com; Kelli Fisher, BSN, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164846-
dc.description.abstractClinical/Evidence Based Practice: Appropriate, timely palliative care referrals allow patients and families to benefit from available resources and enhance quality care. In our 524-bed Level I Magnet Hospital, the palliative care nurse identified that often referrals are received inconsistently, late, and/or on an emergent basis. Oncology nurses possess knowledge and skills needed to screen patients appropriate for palliative care. However, in our 27-bed Oncology unit, nurses lacked a standardized, evidence-based mechanism to identify and initiate palliative care referrals, especially at the end of life. Baseline data uncovered under-utilization as well. We discovered we did not have an efficient, consistent method for alerting the care team to the potential need for palliative care screening. The purpose of this quality improvement project was to develop a screening process designed to trigger referrals earlier in hospitalization or the disease process, in order to provide the highest quality, most appropriate care for our vulnerable population. The Palliative Care Screening Instrument (PCSI; Center to Advance Palliative Care) was piloted for 60 days by the professional nursing staff. Implementation included: standardized education for the nursing staff, initiating screening using the PCSI for each patient, and identifying appropriate patients for referral if they reach the scoring threshold of three. In the 60 days prior to implementation, only 7 referrals were made. In the 60 days which constituted the pilot, all 159 patients admitted were screened, with 90 deemed appropriate for initial referral. The palliative care nurse was notified, and a brief chart review was completed on all 90 patients involving 81 different physicians, not only oncologists. Of these, 30 were referred for palliative care by the physician. The number of palliative care consultations increased more than 4-fold from the number of patients referred in the 2 months previous to the pilot period. Implementation of a palliative care screening process using a standardized tool increased the awareness of early identification for patients who might benefit from palliative care services. These changes allow Oncology nurses to facilitate by increasing communication, coordination, and collaboration of the plan of care. Research is needed to determine the impact of early referral on outcomes.en_GB
dc.date.available2011-10-27T12:08:03Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:08:03Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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