Palliative care incorporating pain management, transitional care planning, and coordination of care as patients move between sites or levels of care can improve patient outcomes and patient satisfaction. This descriptive study explored patient outcomes and satisfaction with palliative care consultations provided by nurse practitioners to patients 60 years or older seen in acute care, skilled nursing facilities, assisted-living facilities, or their own homes. A modified FAMCARE Scale survey measured satisfaction, and a chart audit of 100 initial consults identified documented site of care, diagnosis, pain assessment, recommendations for pain management, advanced care planning, and transitional care planning. Sixty-five percent of the patients reported pain, with most having a diagnosis of cancer, but 57% of these patients had negative intervening events that interfered with pain management. Transitional care was provided for 75% of the patients. Outcomes of the survey included a high rate of satisfaction with care and comfort achievement. This quality improvement study provides an example of palliative care provided by nurse practitioners for a fragile population of older adults as they move between sites or levels of care. Further research should be done studying similar populations upstream and over extended periods.
Susan Mae Parker, DNP, GNP-BC, ACHPN, is director of palliative care, North Shore & Greater Boston DNP Program, University of Massachusetts Lowell.
Ruth Remington, PhD, ANP-BC, GNP-BC, is associate professor, University of Massachusetts Lowell.
Angela Nannini, PhD, FNP-BC, is associate professor, University of Massachusetts Lowell.
Manuel Cifuentes, MD, ScD, is associate professor, University of Massachusetts Lowell.
Address correspondence to Susan Mae Parker, DNP, GNP-BC, ACHPN, 26 Wayside Dr, Danvers MA 01923 (Nasusm412@aol.com).
Dr Parker is the director of the palliative care program under study. The coauthors have no conflict of interest to disclose.