Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing



Date of Original Version



More patients die in intensive care units (ICUs) than in any other hospital setting. For survivors, ICU treatment is often accompanied by a significant burden of symptoms for both the patient and for the family and may result in long-term cognitive and physical impairments and an unacceptable quality of life. Over the last decade, the idea that palliative care should be provided along with intensive care regardless of prognosis has evolved from a novel formulation to a clinical practice guideline. The purpose of this research was to determine whether the patients on a Medical Intensive Care Unit (MICU) were being offered appropriate palliative care. A retrospective chart review of 250 charts was performed at a 653-bed acute care, teaching facility located in southern New England with a sample of 50 patients. The Care and Communication Bundle was used to measure if primary palliative care needs were met; the Palliative Care Service Consult Tool developed by the palliative care team at the study institution was used to measure if tertiary palliative care need s were met. Results indicated approximately 85% compliance with primary palliative care overall, compliance with the individual items ranged from 40% - 100%. Tertiary palliative care compliance was 7% overall, with only two out of 29 patients actually receiving a consult. Recommendations for practice change include integrating the tool into the electronic medical record as part of the admission assessment. Interdisciplinary staff education on the process and use of the measures is indicated. State and national policies related to palliative care would facilitate the implementation of palliative care programs aimed at providing care for all people in need of these services and ensure equitable access to end-of-life care. Advanced practice nurses have a key role in advocating for policy changes within their institutions, as well as, at the state and national levels that could help patients meet their goals of care, especially at the end of their lives.

Included in

Nursing Commons