| Description |
Health-related quality of life (HRQoL) is defined by Healthy People 2020, and addresses aspects of physical, mental, emotional, and social health, and how health status affects and impacts emotions and overall satisfaction with life (USDHHS, 2015). Emergency departments see high volumes of older adults with chronic and acute illnesses and acute exacerbations. The purpose of the emergency department is to save life and limb, and there is an expectation that everything will be done to save a person's life, regardless of the age and health history. However, there may be situations where prolonging one's life, or performing certain procedures, may not result in a positive quality of life. Palliative care may be an appropriate intervention to define goals and preferences of care, particularly in the elderly population. The purpose of the project was to perform a needs assessment of emergency department providers and staff by assessing attitudes and perceptions surrounding emergency departmentinitiated palliative care consults in patients aged 65 and older. The goals of the survey were to identify staff understanding and whether they believe palliative care could be a viable and beneficial option for use in the ED. The objectives include the following: (1) search for appropriate survey tools in the research, and determine which survey instrument I will use, (2) determine logistics of administering the survey, (3) administer the survey and analyze results, and (4) disseminate information internally and externally. Implementation of the above objectives included: IRB approval was obtained, no existing survey was found in the literature so a survey was created to meet the goals of the project, the survey was distributed on paper and, sufficient staff participated, and data were analyzed and reported to staff and a conference abstract was submitted. Evaluation included: a survey to match the project goals was written; participation among providers/nurses was sufficient; participants were willing to take the survey, allowing sufficient data for proper analysis; and findings were printed in a unit newsletter, and a conference application was submitted. Palliative care focuses more on the patient, and on providing interventions that the patient perceives or views as improving or sustaining quality of life. Benefits of palliative care utilization in the hospital have been shown to reduce lengths of stay, prevent or reduce rates of readmission, improve patient and family satisfaction, and reduce health care associated costs (Albanese, et al, 2013; Knott & Hiestand, 2015; Wu, et al, 2013). As people continue to age and live longer, the population of older adults with chronic and acute illness continues to grow, and will require a better use of our resources and re-defining of health care goals. Provider perceptions must be assessed in order to determine readiness, knowledge, and need in the ED. Data from this project will influence future interventions and education required prior to changing practice methods. Future work may address expanding the scope of the current palliative care service into the Emergency Department. |
