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Examination of a Palliative Care Screening Tool in Intensive Care Unit Patients

Lapp, Elizabeth Anne DNP, AGACNP-BC; Iverson, Lindsay DNP, APRN-NP, ACNP-BC

Journal of Hospice & Palliative Nursing: December 2015 - Volume 17 - Issue 6 - p 566–574
doi: 10.1097/NJH.0000000000000202
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No standardized screening tool for the assessment of a patient’s needs for palliative care in the intensive care unit (ICU) exists. This retrospective, descriptive, exploratory study examined the Center to Advance Palliative Care screening criteria, combined to create a tool, to identify patients with a high likelihood of unmet palliative care needs. The investigator reviewed medical records of 200 randomly selected patients admitted to an ICU and used the tool to determine the presence of criteria. The study found that 176 patients (88%) met at least 1 of the screening criteria; 35 of those (19.8%) were referred to palliative care. Of the 200 patients, 31 (15.5%) died in the ICU; 14 (45%) of those received palliative care services before death. The number of screening criteria met was significant in predicting the probability of dying in the ICU (P < .0001). Of the patients who met the most criteria, 16 of 26 (61.5%) utilized palliative care. Findings suggest there is a need for a screening tool to identify patients with a high likelihood of unmet palliative care needs. This tool is a predictor of mortality based on the number of criteria met. Early palliative care should be considered in all patients who meet 1 or more of the Center to Advance Palliative Care screening criteria.

Elizabeth Anne Lapp, DNP, AGACNP-BC, is graduate of Adult-Gerontology Acute Care Nurse Practitioner program, Creighton University College of Nursing, Omaha, Nebraska.

Lindsay Iverson, DNP, APRN-NP, ACNP-BC, is assistant professor, Creighton University College of Nursing, Omaha, Nebraska.

Address correspondence to Elizabeth Anne Lapp, DNP, AGACNP-BC, 1622 S 5th Ave, Sioux Falls, SD 57105 (Elizabeth.Rizzi@gmail.com).

The authors have no conflicts of interest to disclose.

© 2015 by The Hospice and Palliative Nurses Association.