Dissertation
Using the Edmonton Frail Scale to trigger palliative care referral for hospitalized patients with heart failure
Doctor of Nursing Practice (D.N.P.), Drexel University
Jun 2018
DOI:
https://doi.org/10.17918/D82H3B
Abstract
Objective: To determine whether use of the Edmonton Frail Scale (EFS) by the clinical staff on the medical cardiology unit would increase referrals to palliative care for hospitalized patients with heart failure. Design: Quality improvement project based on the Plan, Do, Check, Act framework. Setting/Local Problem: At a 45-bed cardiology unit at an urban academic medical center, frail hospitalized patients with heart failure were not consistently referred to palliative care. Patients: Patients (N=18) admitted with diagnoses of heart failure from July 16, 2016 through July 30, 2018. Intervention/Measurements: Medical cardiology staff were instructed on the on the new process and how to use the EFS. After training, patients with EFS scores greater than or equal to 10 were referred to palliative care. Results: Eighteen patients were admitted with heart failure: 22% (n=4) were referred to palliative care. Of these four, 75% (n=3) were referred because of EFS screening results. One attending physician declined to participate in this project. Overall, palliative care referrals increased from 9% (n=1) before the process change to 17% (n=3) during the two-week pilot. Conclusion: Frailty screening is an objective method with which to identify patients who may benefit from palliative care. Results from this two-week pilot demonstrate process improvement. However, long term sustainability remains questionable. The quality improvement team has committed to continue the pilot for three months. Keywords: palliative care, palliative care referral, heart failure, frailty, goals of care, patient preferences.
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Details
- Title
- Using the Edmonton Frail Scale to trigger palliative care referral for hospitalized patients with heart failure
- Creators
- Monique Neault - DU
- Contributors
- Patti Rager Zuzelo (Advisor) - Drexel University (1970-)Al Rundio (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- 82 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Doctoral Nursing; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 8060; 991014632677904721