Dissertation
Bridging Comfort and Care: Integrating Palliative Approaches in COPD Management Through Screening
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with high symptom burden and healthcare utilization. Patients with COPD are referred to palliative care far less than other progressive or life-limiting diseases (Gore, Brophy, & Greenstone, 2000). Palliative care involvement benefits patients by symptom management, preparedness for disease progression, and advance care planning through advance directives and goals of care discussions. Purpose: The purpose of this project was to increase the utilization of palliative care in the COPD population by creating a screening and referral process through use of a validated screening tool. Methods: The Iowa Model was used for this EBP project. George et al. s (2015) Palliative Care and Rapid Emergency Screening (PCaRES) was the validated screening tool selected for this project and was implemented in an outpatient pulmonary clinic. This tool was converted to a Qualtrics survey with a QR code for easy access. Providers screened COPD patients with the PCaRES tool and if indicated, referral to palliative care was offered. Findings: Screening patients (n=53) with the PCaRES tool increased palliative care referrals by 300 percent which was clinically and statistically significant (p = 0.039). Advance directives increased by 2.3 percent which was not statistically significant. Hospital admissions and emergency department visits decreased by 19.5 percent and 17.5 percent which was statistically significant (p = <0.001). Discussion: Screening patients in the pulmonary clinic was associated with a significant increase in palliative care referrals and a reduction in healthcare utilization. Forty-seven patients qualified for palliative care referral based on screening, however only six patients met with palliative care due to most declining referral. Six patients eventually met with palliative care. The findings in this project demonstrate the need for discovering barriers to acceptance whilst showing the benefit of screening to identify COPD patients who would benefit from palliative care.
Details
- Title: Subtitle
- Bridging Comfort and Care: Integrating Palliative Approaches in COPD Management Through Screening
- Creators
- Kirstin Brainard - University of Iowa
- Contributors
- Nicola Jane Stickney (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Family Nurse Practitioner
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Kirstin Brainard
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841035202771
Metrics
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