Your browser doesn't support javascript.
loading
EMPOWERING END-OF-LIFE CONVERSATIONS: The Role of Specialized Nursing Teams in Facilitating Code Status Changes at Discharge.
Wintz, Diane; Schaffer, Kathryn B; Wright, Kelly; Nilsen, Stacy L.
Afiliación
  • Wintz D; Generational Health Division, Advanced Illness Management, Critical Care, Medicine Department, Sharp HealthCare, Sharp Memorial Hospital Trauma and Acute Care Surgery, San Diego, CA, USA.
  • Schaffer KB; Generational Health Division, Advanced Illness Management, Critical Care, Medicine Department, Sharp HealthCare, Sharp Memorial Hospital Trauma and Acute Care Surgery, San Diego, CA, USA.
  • Wright K; Generational Health Division, Advanced Illness Management, Critical Care, Medicine Department, Sharp HealthCare, Sharp Memorial Hospital Trauma and Acute Care Surgery, San Diego, CA, USA.
  • Nilsen SL; Generational Health Division, Advanced Illness Management, Critical Care, Medicine Department, Sharp HealthCare, Sharp Memorial Hospital Trauma and Acute Care Surgery, San Diego, CA, USA.
J Palliat Care ; : 8258597241283303, 2024 Sep 19.
Article en En | MEDLINE | ID: mdl-39295506
ABSTRACT

Objectives:

Hospitalized patients may require goals of care (GOC) or Advance Health Care Planning (ACP), which can be time-consuming and emotionally tolling for providers. A nursing team specializing in code status (CODE), GOC, and ACP was developed to provide meaningful support for patients and families and decrease provider burden. Interest in CODE, GOC, ACP, and effectiveness of a nursing team to lead these conversations prompted this study.

Methods:

A collaborative nursing team was trained to address CODE, GOC, and ACP with patients demonstrating illness or geriatric syndrome. This team conducted 3 visits per patient on average during hospitalization using structured CODE templates to establish longer term goals and document what matters in the healthcare journey. Comprehensive narratives for ACP and GOC were included in charting, syncing the medical team, nursing, patient, and family. Consults were tracked over nine months with data reviewed retrospectively from medical charts. Descriptive analyses of cohort demographics, CODE and outcomes were completed.

Results:

The study group comprised 3342 patients between October 2022 and June 2023. Patients ranged in age from 18-106 years, with majority (88%) age 65 years and older. Mean length of stay (LOS) was 6.8 days with CODE documented for 91% upon admission. Of the 3166 older adults with known CODE on admission, 946 (30%) changed CODE by discharge, of which 95% were de-escalated. 83% of older patients arriving with limited CODE maintained limitations at discharge, with a small portion converting to comfort (16%).

Conclusion:

Employing a focused nursing team to conduct CODE, GOC, and ACP conversations may be an effective use of time and resources and result in de-escalation of resuscitation orders for patients demonstrating illness or geriatric syndrome.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Palliat Care Asunto de la revista: SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Palliat Care Asunto de la revista: SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos