Date of Graduation


Document Type


Degree Type



School of Nursing


Family/Community Health

Committee Chair

Gina Maiocco

Committee Co-Chair

Patty Hermosilla

Committee Member

Alvin Moss.


Body: Twenty percent of all Americans die in an intensive care unit (ICU) or shortly thereafter. For most of these patients, relentless and distressing symptoms are commonplace. Review of local data reveals opportunity for improvement in the palliative care offered to hospitalized patients. To address this need for improved palliative care, the Volunteer Hospital Association's (VHA) Communication and Care Bundle will be implemented in a local medical ICU, using Roger's (2003) diffusion of innovations (DOI) as the theoretical base.;Evaluation: Communication and Care Bundle within a given time frames, for select medical ICU patients. ICU length of stay and patient mortality were also assessed before and after the multifaceted intervention.;Results: The implementation of the Communication and Care Bundle.;Discussion and Recommendations: The adoption of the Communication and Care Bundle has been shown to increase documentation of three of the nine quality measures in the medical intensive care unit (MICU) and surgical intensive care unit (SICU) for adult medical intensive care patients at high risk of death. Further inquiry is needed to fully examine why all quality measures did not significantly increase.