Assessment of Palliative Care Needs in a Kenyan Intensive Care Unit Using a Trigger-Based Model.

2021 ◽  
Author(s):  
Linda Barasa ◽  
Jasmit Shah ◽  
John Weru ◽  
Sayed Ali Karar
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Care Needs ◽  
Palliative Care Needs

Palliative Care in the Intensive Care Unit

2018 ◽  
Author(s):  
Margaret L. Isaac ◽  
J. Randall Curtis
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Information Quality ◽  
Life Support ◽  
Symptom Assessment ◽  
Care Needs ◽  
Prognostic Information ◽  
Screening Criteria ◽  
Palliative Care Needs

Palliative care is increasingly recognized as an important component of care for all critically ill patients and should include both improving the primary palliative care skills of all clinicians working in the intensive care unit (ICU) as well as incorporating palliative care specialists for patients and families with unmet palliative care needs. This chapter highlights the key issues related to palliative care in ICU and evidence-based strategies to manage these issues. Topics covered include screening criteria to help identify patients with a high likelihood of unmet palliative care needs, withdrawal of life support (checklist and communication), providing prognostic information, quality indicators for end-of-life care in the ICU, and symptom assessment and management in the ICU.

I’ve Got the Power: Nurses’ Moral Distress and Perceptions of Empowerment

2021 ◽  
Vol 30 (6) ◽  
pp. 461-465
Author(s):  
Kathleen A. DiGangi Condon ◽  
Jeffrey T. Berger ◽  
Kathleen M. Shurpin
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Screening Tool ◽  
Moral Distress ◽  
Care Needs ◽  
Course Of Action ◽  
Palliative Care Services ◽  
Workplace Empowerment ◽  
Distress Scale

Background Nurses experience moral distress when they feel disempowered or impeded in taking the ethically right course of action. Research suggests an inverse relationship between moral distress and empowerment. In the intensive care unit, providing palliative care services may reduce moral distress because palliative care is often provided in situations that give rise to moral distress. Objective To evaluate the effect of nurses’ use of a palliative care screening tool on their moral distress and perceptions of empowerment. Methods A pretest-posttest pilot study was conducted involving day-shift medical intensive care unit nurses. The nurses administered a palliative care screening tool to their assigned patients daily for 8 weeks and communicated the results to an attending physician or fellow. Demographic information was collected, along with data on nurses’ moral distress and perceptions of structural and workplace empowerment before and after the intervention. Moral distress was evaluated using the Moral Distress Scale–Revised. Perceptions of structural and workplace empowerment were quantified using the Conditions for Work Effectiveness Questionnaire–II and the Global Empowerment Scale, respectively. Results Preintervention and postintervention surveys were completed by 17 nurses. Paired-sample t tests revealed a significant decrease in the frequency of moral distress (t16 = −2.22, P = .04) and a significant increase in workplace empowerment (t16 = −2.75, P = .01). No significant changes in moral distress intensity or structural empowerment were found. Conclusion Nurses’ sense of empowerment and the frequency of moral distress are favorably affected by active participation in assessing and communicating patients’ palliative care needs.

scholarly journals An Evaluation of the Palliative Care Provided on a Medical Intensive Care Unit

2015 ◽  
Author(s):  
Peter Musso
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Care Service ◽  
Hospital Setting ◽  
Palliative Care Service ◽  
Practice Change ◽  
Care Needs ◽  
Medical Intensive Care

<p>More patients die in intensive care units (ICUs) than in any other hospital setting. For survivors, ICU treatment is often accompanied by a significant burden of symptoms for both the patient and for the family and may result in long-term cognitive and physical impairments and an unacceptable quality of life. Over the last decade, the idea that palliative care should be provided along with intensive care regardless of prognosis has evolved from a novel formulation to a clinical practice guideline. The purpose of this research was to determine whether the patients on a Medical Intensive Care Unit (MICU) were being offered appropriate palliative care. A retrospective chart review of 250 charts was performed at a 653-bed acute care, teaching facility located in southern New England with a sample of 50 patients. The Care and Communication Bundle was used to measure if primary palliative care needs were met; the Palliative Care Service Consult Tool developed by the palliative care team at the study institution was used to measure if tertiary palliative care need s were met. Results indicated approximately 85% compliance with primary palliative care overall, compliance with the individual items ranged from 40% - 100%. Tertiary palliative care compliance was 7% overall, with only two out of 29 patients actually receiving a consult. Recommendations for practice change include integrating the tool into the electronic medical record as part of the admission assessment. Interdisciplinary staff education on the process and use of the measures is indicated. State and national policies related to palliative care would facilitate the implementation of palliative care programs aimed at providing care for all people in need of these services and ensure equitable access to end-of-life care. Advanced practice nurses have a key role in advocating for policy changes within their institutions, as well as, at the state and national levels that could help patients meet their goals of care, especially at the end of their lives.</p>

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