Integrating palliative care and end of life care concepts for surgical ICU patients and staff

Abstract

Integrating palliative care and end of life care principles can be challenging in a surgical ICU setting as traditional goals of care for surgical patients are focused on promoting recovery. Because of this, the staff in the SICU formed a palliative care committee and a series of initiatives were implemented to promote education and awareness of palliative care and end of life care issues, as well as identify triggers for palliative care consultations, as a part of the post surgical care for patients with complex conditions. These interventions included establishing a palliative care journal club which was held monthly and reviewed topics ranging from the family or surgeon perspective of end of life care or how to approach surgeons to discuss palliative care, participation in Schwartz Grand Rounds that promoted a discussion on complicated length of stays for transplant patients, and development of a weekly family support group.

Pre-intervention surveys were completed on nursing staff attitudes and knowledge of palliative and end of life care. Results showed that 77% of nurses did not have palliative care education and 57% said no or didn't know if palliative care was compatible with aggressive care. Post-implementation surveys will be conducted in spring 2012. This presentation will further describe the initiatives that proved beneficial in engaging ICU nurses in discussion and learning of palliative care and end of life care concepts. Strategies that were used to promote education for clinical nurses and the results of post implementation benefit assessments will be highlighted.