PALLIATIVE CARE: A NEW STANDARD

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1 PALLIATIVE CARE: A NEW STANDARD Small Test of Change Presentation Amanda Ladner

2 PALLIATIVE CARE Palliative care is for anyone facing chronic or short-term illness and focuses on pain and symptom control in a multidisciplinary fashion. The goal is to improve the quality of life for both the patient and family (either physically, mentally, and/or emotionally) Right now nearly 6,000,000 people in the United States qualify for palliative care interventions

3 PICO P= patients facing end-stage or chronic illness I= implementing a specific palliative care intervention such as counseling and or emotional support C= in addition to usual hospice care O= improve the overall emotional health and quality of life for those entering their last days

4 EBP RECOMMENDATIONS Grade Recommendation A B Palliative care that addresses religious concerns, grieving support, and coping strategies are essential components of providing patient-centered palliative care. Provide patient-centered palliative care that considers patient preference, dignity therapy, and focused narratives throughout the palliative care process.

5 CLINICAL SETTING Clinical setting chosen is the ICU at Jackson Hospital in Montgomery, AL Population demographics The palliative care team includes an MD, PA, and RN that work collectively to provide holistic palliative care on a consult-basis to inpatients Decided that two significant issues that are faced on a daily basis are the lack of awareness of the role of the palliative care team and determining the patient s preference in his or her end-of-life care

SMALL TEST OF CHANGE Aim: Achieve 100% awareness and knowledge on patient-centered palliative care by introducing the PACE tool to ICU staff members

6 SMALL TEST OF CHANGE Aim: Achieve 100% awareness and knowledge on patient-centered palliative care by introducing the PACE tool to ICU staff members Provides a baseline PACE tool includes family details, social details, patient preference information, and communication preferences (see reference)

7 RELEVANCE TO PROJECT Overall goal: to implement PACE tool in the ICU to a set number of patients to improve quality of life Small Test of Change will provide more information on the barriers and facilitators that will affect overall project Will inform those that are closest to the patients about the importance of patientcentered palliative care

8 IMPLEMENTATION PLAN Organize an in-service meeting of approximately 5-8 nurses in the ICU to assess for general knowledge and enthusiasm for palliative care Q & A style, possible questionnaire at this time Early in next semester January, 2015 Introduce the PACE tool as an effective way to provide patient-centered care Assess the general opinion about the PACE tool

9 EVALUATION PLAN Outcome Measures: goal is to improve quality of life for patients, starts with those giving the patients care Did the test of change PACE tool improve palliative care interventions? Will hold a meeting 4 weeks later (February, 2015) to evaluate the effectiveness of the tool Will provide the same 5-8 nurses with a questionnaire to evaluate the general knowledge and acceptance of the PACE tool Impact on stakeholders

10 Barriers Facilitators 1. Lack of awareness of palliative care team and their services 2. Lack of knowledge concerning when and why palliative care should be consulted 3. The business of everyone s schedule and the coordination of getting people to attend a meeting that is not mandatory 4. Ability to have the time and acceptance from management to implement this step with direct patient contact 1. Majority of patient care givers and family members seek to do what is best for their loved ones 2. Most people involved in direct patient care are concerned about the quality and improvement of the patient s life 3. Palliative care team can be used as a valuable resource for opinions and expertise 4. Will provide a reliable tool for implementation to improve quality of life

11 QUESTIONS & CONCERNS

12 REFERENCES Center to Advance Palliative Care Get palliative care. Retrieved from Higginson, I.J., Koffman, J., Hopkins, P., Prentice, W., Burman, R., Leonard, S Shipman, C. (2013). Development and evaluation of the feasibility and effects on staff, patients, and families of a new tool, the psychosocial assessment and communication evaluation (PACE), to improve communication and palliative care in intensive care and during clinical uncertainty. BioMed Central Medicine, 11, Retrieved from /11/213 (2014). Palliative care is an essential part of cancer control. Retrieved from

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PALLIATIVE CARE: A NEW STANDARD

PALLIATIVE CARE: A NEW STANDARD Small Test of Change Presentation Amanda Ladner PALLIATIVE CARE Palliative care is for anyone facing chronic or short-term illness and focuses on pain and symptom control