Critical Care Nurses Can Champion Palliative Care

Article in Critical Care Nurse describes barriers to palliative care consultations, offers strategies to integrate palliative care into critical care

Newswise, October 1, 2015 — Palliative care, a specialized form of medical care providing relief from symptoms or stress of life-threatening illnesses, provides proven benefits to critically ill patients with life-threatening illnesses, yet barriers to palliative care consultations prevent many patients and their families from discussing it with their team of healthcare providers, according to an article in the October issue of Critical Care Nurse(CCN).

The article, “Overcoming Barriers to Palliative Care Consultation,” offers nursing-specific strategies to help hospitals better integrate palliative care into everyday critical care and encourage widespread adoption of palliative care services.

Palliative care has evolved into a service that provides psychological, spiritual, goal-setting and decision-making support to patients with life-threatening illnesses and their families. The benefits of such care include early initiation of comfort-focused treatment goals, decreased length of stay, reduced cost of care without an increase in mortality, and continuity of care.

Unlike hospice care, palliative care is appropriate early in the course of illness, and patients can be simultaneously treated for their condition, including therapies intended to prolong life.

Lead author Kathleen Ouimet Perrin, RN, PhD, CCRN, is a professor of nursing at Saint Anselm College, Manchester, New Hampshire, where she teaches critical care nursing and understanding suffering.

“Patients receiving palliative care have better quality of life and live longer but cost the healthcare system less. Still, many patients are not offered the opportunity to receive a palliative care consultation,” she said.

Misunderstandings about palliative care and not having agreed-upon criteria for referral are common reasons consultations are not suggested to critically ill patients and their families.

The article recommends strategies critical care nurses can use to overcome these barriers, including:
• educating other healthcare providers about the purpose and benefits of palliative care to increase understanding and support
• emphasizing to other healthcare providers and patients’ families that symptom management can improve patient outcomes
• emphasizing to other healthcare providers that palliative care providers have more time and more options for symptom management, which improves the quality of care
• advocating for development and use of specific criteria or trigger situations that require a palliative care consultation
• working with other healthcare providers to ensure that a consistent message is provided to patients and their families

“To overcome barriers to palliative care consultation, critical care nurses need to be champions for palliative care on the policy level of the hospital and the unit and on the level of individual patients,” Perrin said.

The article notes that nurses’ involvement in decision-making discussions related to goals of care can also limit their own moral distress.

The American Association of Critical-Care Nurses, which publishes CCN, offers resources and tools to help nurses care for patients and their families at the most difficult times of their lives, including an e-learning course and a free, online self-assessment tool. For more information on palliative and end-of-life care, please visit www.aacn.org/palliativeedu.

As AACN’s bimonthly clinical practice journal for high acuity, progressive and critical care nurses, CCN is a trusted source for information related to the bedside care of critically and acutely ill patients.

Access the article abstract and full-text PDF by visiting the CCN website at http://ccn.aacnjournals.org/.

About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high acuity, progressive and critical care settings. CCN enjoys a circulation of more than 100,000 and can be accessed at http://ccn.aacnjournals.org/.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. www.aacn.org ; facebook.com/aacnface; twitter.com/aacnme