Use of the palliative performance scale version 2 in obtaining palliative care consults

摘要

Aims and objectives: To examine whether an educational intervention and implementation of a validated prognostication tool can improve inpatient acute care nurses' knowledge of palliative care and their comfort in determining the need for palliative care and requesting a palliative care consult from the attending physician. Background: Patients with chronic illness report low levels of quality of life. Relief from suffering may be found in services provided by palliative care; however, their services are often underused, in part, due to difficulties in prognostication. The Palliative Performance Scale version 2 is a prognostication tool that can help overcome this barrier. Design: A pretest/post-test design with nursing education intervention was used on an acute care medical unit within a Midwest tertiary hospital. Method: Survey questions for both pre- and postintervention assessed nurses' knowledge related to palliative care and examined nurses' comfort in identifying patients appropriate for palliative care and requesting consults. Following the presurvey, education on palliative care and the use of the Palliative Performance Scale version 2 was provided during a regularly scheduled staff meeting. Posteducation mentoring occurred for one month prior to the postsurvey. Results: Pre- and post-test comparisons showed an overall increase in both comfort and knowledge related to palliative care. There was also a significant improvement in the nurses' comfort in identifying patients appropriate for palliative care. Conclusions: Findings suggest that nursing education on palliative care and Palliative Performance Scale version 2 can improve their knowledge level and comfort in requesting palliative care consults. Relevance to clinical practice: Nurses are in the best position to advocate for the patient and the management of their chronic illness. Educating nurses on the philosophy of palliative care and improving their comfort level in assessing the need for palliative care will overcome barriers to consultation.