Needs Assessment for a Chaplain Program in a Thoracic Intensive Care Unit

Extensive research underscores the positive correlation between nurses' engagement with spirituality and improved patient outcomes. Despite the acknowledged significance of addressing patients' spiritual needs, there is an underutilization and lack of coordination of available chaplain services, particularly in critical care settings. Patients and nurses are challenged by the lack of spiritual care. Local Problem: A Thoracic Intensive Care Unit (TICU) at a major referral center recognized the general need for more available and greater understanding within their unit of how to utilize chaplain services for supportive care with hospitalized patients and the coordination of spiritual and emotional support by the interdisciplinary team. Chaplain services have been introduced into this facility; however, a significant gap exists in the availability of chaplains and other spiritual services to support patients across various critical care settings, exacerbating the challenge of providing holistic patient care. Approach/Methods: This quality improvement project utilized the Johns Hopkins Evidence- Based Practice Model. A comprehensive literature review identified best practices in spiritual care and chaplain program integration, and the link between chaplain services and hospitalized patients focused on the interdisciplinary team. Interventions: A SWOT (strengths, weaknesses, opportunities, and threats) analysis included assessing the current national and regional benchmarks for chaplains, the current culture within the TICU, what has historically been done, and what can be done to improve the utilization of chaplains in the TICU. Focused discussions with chaplains were conducted, and themes were identified that informed the creation of an interdisciplinary needs assessment survey and questionnaire. A REDCap survey was conducted with the TICU interdisciplinary team to evaluate current spirituality knowledge and its relationship to patient care in the intensive care unit. The survey identified gaps in utilizing chaplains and spiritual support in the TICU. Semi-structured interviews were conducted through convenience samples with the nurses in the TICU that focused on what spiritual and emotional support could be improved by fully utilizing chaplains. Results: The survey results analysis underscores respondents' robust support for addressing spiritual needs within the TICU; 87% of the interdisciplinary team agree or strongly agree that it is essential to address patients' spirituality. The thematic analysis of the qualitative data further supports the chaplains' crucial role in helping families and the healthcare staff. Recommendations for a strategic plan for a chaplaincy program were developed based on evaluating the survey and interview outcomes, literature review, best practices, and comparing current practices with the national standards of chaplain programs. Conclusions: Key recommendations to better meet the spiritual needs of patients include a multifaceted approach: (1) A strategic plan to bridge the current gaps in spiritual care within the TICU (2) A need to standardize the approach to spiritual assessments with patients in the TICU, (3) Engage with the interdisciplinary team to create a heightened awareness of chaplain support for all patient care, (4) Comprehensive training should be conducted for healthcare providers to address the identified gaps. This thorough strategy aims to address patients' immediate needs and fosters a more resilient and spiritually attuned healthcare environment.