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Dissertation
Palliative Care Screening in Patients with Advanced Heart Failure
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2024
Abstract
Background: Heart failure (HF) imposes a significant burden on healthcare systems worldwide, with its prevalence expected to rise in the coming years (Savarese & Stanek, 2023). Despite advances in treatment, HF continues to be associated with severe symptoms and high mortality rates. Palliative care (PC) has emerged as a vital component in managing HF, aiming to improve patients' quality of life (Kavalieratos et al., 2017). However, identifying and referring patients who would benefit from PC remains a challenge in clinical practice. Purpose: This project aimed to develop and implement a Modified SPICT screening tool to identify patients with advanced HF who would benefit from PC in an outpatient cardiomyopathy clinic setting. Methods: Employing the Iowa Model-Revised Evidence-Based Practice as its framework, this initiative introduced the Modified SPICT tool to a setting previously lacking a screening tool. The project focused on three primary outcomes: the rate of screening completion for new patients, the frequency of palliative care referrals following positive screenings, and staff satisfaction with the screening tool. Findings: Post-implementation, the rate of screening new patients for palliative care needs increased dramatically to 72.97% from none previously. Of those screened, 26% (n=7) were identified as needing PC, resulting in referrals for two patients. Despite these advances, challenges like provider reluctance and patient refusal limited referral rates. Additionally, a qualitative analysis indicated no significant correlation between positive screenings and factors such as age, ejection fraction, or specific cardiac diagnoses. Discussion: This project underscores the importance of integrating palliative care into HF management and highlights the need for ongoing research to develop effective screening tools and overcome barriers to accessing PC services for this population. References Kavalieratos, D., Gelfman, L. P., Tycon, L. E., Riegel, B., Bekelman, D. B., Ikejiani, D. Z., Goldstein, N., Kimmel, S. E., Bakitas, M. A., & Arnold, R. M. (2017). Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities. Journal of the American College of Cardiology, 70(15), 1919–1930. https://doi.org/10.1016/j.jacc.2017.08.036 Savarese, A., & Stanek, J. (2023). Screening and Implementing Palliative Care Measures in Heart Failure: A Guide for the Primary Care Nurse Practitioner. Journal for Nurse Practitioners, 19(7), N.PAG. https://www.npjournal.org/article/S1555-4155(23)00152-6/fulltext
Details
- Title: Subtitle
- Palliative Care Screening in Patients with Advanced Heart Failure
- Creators
- Caitlyn Jo Al-Ostaz - University of Iowa
- Contributors
- Heather Dunn (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 2024
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2024 Caitlyn Jo Al-Ostaz
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984627255002771
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