Examining the Comfort and Knowledge of Nurse-Driven Palliative Care Screenings on Admission to the Neuro ICU.

Abstract

Neurocritical intensive care unit (ICU) patients are not routinely screened for palliative care (PC) consultations. Unmet PC needs can delay establishing goals of care, increase the length of stay, and decrease patient and family satisfaction. Nurses can best advocate for appropriate PC referrals when given adequate resources and tools. Nurse-driven screening results in more appropriate PC recommendations. The project was a descriptive pre/post evidence-based practice intervention design. An electronic survey on comfort and knowledge of PC was distributed to neurocritical ICU nurses before and after an educational intervention regarding the definition of PC and the use of the Center to Advance PC's ICU screening tool. Nurses' comfort when assessing for PC consults increased from 62.5% to 91.7%, and for requesting consults from a physician, from 58.4% to 75%. Nurses' knowledge of PC being compatible with aggressive treatment increased from 41.7% to 95.8%. Nurses recommended PC in 66.7% of patients based on 3 or more screening criteria selected. The screening tool highlighted that more than 62% of patients in the neurocritical ICU had a PC need on admission. Implementing a screening tool and educational intervention can increase nurses' comfort and knowledge in recommending PC consults. The screening tool effectively identified patients with PC needs, empowering nurses to advocate for appropriate PC referrals.