Abstract

Palliative care (PC) encompasses a holistic way of caring for patients and families with chronic disease or life-limiting illness through optimal symptom management. Individuals in need of PC has reached 20 million annually world-wide. Many patients in need of this service never receive a consultation, or if they do, it comes late in the disease process. Some health care specialists see PC as incongruent with treatment, while others have a lack of understanding of what this service provides. Additionally, many providers have few or no resources to guide in the recognition of PC needs. This practice improvement project emphasized identification of chronically ill patients in need of PC through the use of the Supportive and Palliative Care Indicators Tool (SPICT), coupled with a thorough assessment by a nurse practitioner (NP) in an outpatient clinic in Yuma, Arizona. The project used a mixed-method design with qualitative data obtained through face-to-face interviews with the NPs and a questionnaire. Quantitative analysis occurred through comparison of the number of PC candidates with and without the use of the SPICT tool. Results showed that the SPICT tool, coupled with a thorough assessment, increased the NP's recognition of PC needs by 34%, and guided them in initiating a PC discussion with the patient and family. A thorough assessment, coupled with the SPICT screening tool can assist the practitioner in recognizing chronically ill patients in need of PC, thus increasing the potential for referral in a timely fashion. This may positively impact symptom management and quality of life.

Norma H. Clark

Author Details

Norma Heather Clark, DNP, RN completed all requirements for the Doctor of Nursing Practice and graduated on May 11, 2019.

Sigma Membership

Lambda Omicron

Lead Author Affiliation

Northern Arizona University, Flagstaff, Arizona, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Pilot/Exploratory Study

Keywords:

Palliative Care, Communication, SPICT, Hospice and Palliative Nursing, Palliative Care--Utilization, Clinical Indicators, Clinical Assessment Tools, Nurse Practitioners, Professional-Patient Relations, Communication, Palliative Care

Advisor

Borchers, Andrea

Second Advisor

Rivas, Dawn

Degree

DNP

Degree Grantor

Northern Arizona University

Degree Year

2019

Rights Holder

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

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