31 Jan

A newly developed screening tool can detect which patients may benefit from palliative care sessions in a few seconds. According to the researchers, it can aid clinicians in surgical critical care units in making decisions on palliative care and raise knowledge of the approach.

The technique is more specific than other screening measures for identifying palliative care needs. It may help minimize the length of hospital stays for ICU patients nearing death.

A team at the University of North Carolina at Chapel Hill has created a novel palliative care screening instrument for surgical procedures (UNC-Chapel Hill). The program identifies ICU patients who may benefit from a palliative care consultation within seconds.

It has been demonstrated that palliative care reduces symptoms, improves the quality of life, and reduces resource use in patients with advanced illnesses. However, the majority of those who require palliative care are not identified.

The objective of this study was to establish a feasible and reliable palliative care screening tool for identifying emergency department patients with significant unmet palliative care requirements. Expert palliative care clinicians validated the tool's content, which was produced utilizing a quality improvement process.

Existing screening techniques for palliative care needs in primary care and the emergency department include a variety of instruments. Numerous of these techniques employ a vast array of general and disease-specific markers as surrogates for the identification of individuals who may have palliative care needs.

The test aims to assist doctors in surgical intensive care units in identifying patients who may benefit from quality-of-life-focused palliative care talks. This is particularly crucial when aggressive medical therapies do not enhance outcomes or prolong life.

Frequently, however, the medical staff is hesitant to recommend palliative care out of concern that it may increase families' anxiety and uncertainty. The UNC researchers wished to develop a simple screening instrument that might indicate in a few seconds whether patients could benefit from early talks of goals of treatment.

The study employed electronic medical records, a pre/post design, and clinical staff surveys as part of a quality improvement initiative. Implementing the screening tool boosted the aim of care talks, the study revealed.

During the perioperative period, patients frequently face difficult care decisions. These include the decision to proceed with surgical procedures and postoperative therapies that may be onerous.

Before surgery, it is essential to establish a patient's desired outcome and treatment preferences to help them and their family negotiate these difficult, moment-to-moment decisions. Preexisting directives barring specific procedures and the short- and long-term impacts of surgery on their functional status and quality of life may influence these expectations.

Several studies have examined screening techniques for identifying people who may require palliative care. Most of these methods utilize a combination of disease-specific and generic indications, such as symptoms or clinical indicators, to forecast death and deterioration and identify potential palliative care needs.

The novel instrument was created with the surgical team, which included physicians, nurses, and advanced practice providers. It consists of 12 "yes/no" questions that identify patients who could benefit from palliative care consultations or discuss treatment goals.

The tool aims to enhance communication between the surgical and palliative care teams before surgery. This could lessen the likelihood of patient-harming errors such as wrong-patient, wrong-side, and retained foreign items.

It is conceivable to utilize the gadget for surgical procedures. However, its effectiveness has significant restrictions. For instance, various views of preoperative imaging studies cannot be viewed.

However, the device might be utilized for surgical procedures, and it is now in use at UNC-Chapel Hill. It could facilitate the identification of individuals requiring palliative care and the completion of advance directives.

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