Semester

Summer

Date of Graduation

2020

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Committee Chair

Lori Constantine

Committee Member

Anand Pullapilly

Abstract

Review of local data and concerns from nursing staff revealed the need to improve palliative care in a local, community hospital Intensive Care Unit (ICU). This effort was mobilized by implementing the Care and Communication Bundle within evidence-based time frames, into this local, community ICU, using Lewin’s Change theory as a guide for implementation. The Care and Communication Bundle is a grouping of nine palliative, quality measures found to improve palliative care in the ICU. A pre/post-educational intervention evaluated if the implementation of the Care and Communication Bundle in the ICU improved palliative care by reviewing the documentation of the nine, palliative, quality measures within selected time frames. The implementation and adoption of the Care and Communication Bundle in a local, community ICU significantly increased four of the nine, palliative, quality measures within those periods. These four measures included palliative leaflet distribution (p-value < 0.01), social work visitation (p-value = 0.02), spiritual care support (p-value < 0.01), and the completion of an interdisciplinary meeting (p-value < 0.01). The five, palliative, quality measures that did not show significant improvement included documentation of appropriate medical decision maker (p-value = 0.44), an advance directive on the chart (p-value = 0.07), resuscitation status (p-value = 0.24), regular pain assessment, and optimal pain management.

Share

COinS