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Increasing Palliative Consults for Heart Failure Inpatients Using the Seattle Heart Failure Model

James, Toni MSN, RN, CNL, CHPN; Offer, Melinda MSN, RN; Wilson, Marian MPH, RN, CHPN; Delyea, Audra BSN, RN; Johnson, Dawn RN, BS

Journal of Hospice & Palliative Nursing: September-October 2010 - Volume 12 - Issue 5 - p 273-281
doi: 10.1097/NJH.0b013e3181e0866b
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Heart failure is a common hospital admission diagnosis and a progressive terminal disease. Prognosis is difficult to predict, and patients are often unaware of their poor prognosis. The Seattle Heart Failure Model is a tool that predicts life expectancy for heart failure patients. The aim of this study was to determine if this tool could identify heart failure inpatients who would benefit from palliative care referrals. The tool was applied retrospectively to 214 patients with a discharge diagnosis of heart failure. Cases were divided for data analysis into three groups of predicted baseline life expectancy: those with prognosis of less than or equal to 1.5 years, more than 1.5 years to less than 5 years, and 5 years or more. Of those with life expectancy equal to or less than 1.5 years, 63% of these patients (n = 17) would have received timely palliative care consultation had the Seattle Heart Failure Model been used as a screening tool. More research is needed to explore the use of this tool and others for inpatients with heart failure. Such tools can be helpful in ensuring that patients receive the information they need to make end-of-life decisions.

Author Affiliations: Toni James, MSN, RN, CNL, CHPN, Palliative Nurse Coordinator, Kootenai Medical Center, Coeur d'Alene, ID.

Melinda Offer, MSN, RN, Performance Improvement Partner, Kootenai Medical Center, Coeur d'Alene, ID.

Marian Wilson, MPH, RN, CHPN, Nursing Research Coordinator, Kootenai Medical Center, Coeur d'Alene, ID.

Audra Delyea, BSN, RN, Case Manager, Kootenai Medical Center, Coeur d'Alene, ID.

Dawn Johnson, RN, BS, Case Management, Kootenai Medical Center, Coeur d'Alene, ID.

This study was funded by Kootenai Medical Center.

Address correspondence to Toni James, MSN, RN, CNL, CHPN, Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d'Alene, ID 83814 (tjames@kmc.org).

© 2010 The Hospice and Palliative Nurses Association