Integrating palliative and critical care: Description of an intervention

Patsy D. Treece, Ruth A. Engelberg, Sarah Shannon, Elizabeth L. Nielsen, Theresa Braungardt, Gordon D. Rubenfeld, Kenneth P. Steinberg, J. Randall Curtis

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

A large proportion of deaths in the United States occur in the intensive care unit (ICU) or after a stay in the ICU, and there is evidence of problems in the quality of care these patients and their families receive. In an effort to respond to this problem, we developed a multifaceted, nurse-focused, quality improvement intervention that is based on self-efficacy theory applied to changing clinician behavior. We have called the intervention "Integrating Palliative and Critical Care." This five-component intervention includes: 1) critical care clinician education to increase knowledge and awareness of the principles and practice of palliative care in the ICU, 2) critical care clinician local champions to provide role modeling and promote attitudinal change concerning end-of-life care, 3) academic detailing of nurse and physician ICU directors to identify and address local barriers to improving end-of-life care in each ICU, 4) feedback of local quality improvement data, and 5) system supports including implementation of palliative care order forms, family information pamphlets, and other system supports for providing palliative care in the ICU. The goal of this report is to describe the conceptual model that led to the development of the intervention, and for each of the five components, we describe the theoretical and empirical support for each component, the content of the component, and the lessons we have learned in implementing the component. Future reports will need to examine the ability of the interventions to improve outcomes of palliative care in the ICU.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume34
Issue number11 SUPPL.
DOIs
StatePublished - Nov 2006
Externally publishedYes

Fingerprint

Critical Care
Palliative Care
Intensive Care Units
Terminal Care
Quality Improvement
Nurses
Pamphlets
Aptitude
Quality of Health Care
Self Efficacy
Information Systems
Physicians
Education

Keywords

  • Critical care
  • Death
  • Dying
  • End-of-life care
  • Intensive care
  • Palliative care
  • Withdrawing life support

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Treece, P. D., Engelberg, R. A., Shannon, S., Nielsen, E. L., Braungardt, T., Rubenfeld, G. D., ... Curtis, J. R. (2006). Integrating palliative and critical care: Description of an intervention. Critical Care Medicine, 34(11 SUPPL.). https://doi.org/10.1097/01.CCM.0000237045.12925.09

Integrating palliative and critical care : Description of an intervention. / Treece, Patsy D.; Engelberg, Ruth A.; Shannon, Sarah; Nielsen, Elizabeth L.; Braungardt, Theresa; Rubenfeld, Gordon D.; Steinberg, Kenneth P.; Curtis, J. Randall.

In: Critical Care Medicine, Vol. 34, No. 11 SUPPL., 11.2006.

Research output: Contribution to journalArticle

Treece, PD, Engelberg, RA, Shannon, S, Nielsen, EL, Braungardt, T, Rubenfeld, GD, Steinberg, KP & Curtis, JR 2006, 'Integrating palliative and critical care: Description of an intervention', Critical Care Medicine, vol. 34, no. 11 SUPPL.. https://doi.org/10.1097/01.CCM.0000237045.12925.09
Treece PD, Engelberg RA, Shannon S, Nielsen EL, Braungardt T, Rubenfeld GD et al. Integrating palliative and critical care: Description of an intervention. Critical Care Medicine. 2006 Nov;34(11 SUPPL.). https://doi.org/10.1097/01.CCM.0000237045.12925.09
Treece, Patsy D. ; Engelberg, Ruth A. ; Shannon, Sarah ; Nielsen, Elizabeth L. ; Braungardt, Theresa ; Rubenfeld, Gordon D. ; Steinberg, Kenneth P. ; Curtis, J. Randall. / Integrating palliative and critical care : Description of an intervention. In: Critical Care Medicine. 2006 ; Vol. 34, No. 11 SUPPL.
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