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Original Research| Volume 19, ISSUE 4, 104542, April 2023

The Impact of Embedding a Palliative Care Advance Practice Provider on a Neuroscience Intensive Care Unit Service

Published:February 10, 2023DOI:https://doi.org/10.1016/j.nurpra.2023.104542

      Highlights

      • Providers have noted that they prefer a collaborative approach when the palliative care (PC) service is involved in the hospital setting in order to provide the best patient care.
      • Taking care of patients with neurology conditions can be an extremely demanding task, oftentimes resulting in the need for complex medical decision making and difficult conversations related to end-of-life and symptom management.
      • There are widespread misconceptions and stigma surrounding the involvement of PC, specifically with the neuroscience patient population, that are at times difficult to transcend.
      • In order to better understand and inform patients about the potential benefits that could be derived from PC, as well as to improve the frequency and involvement of PC in neuroscience intensive care unit (ICU) patients, a consistent PC provider was embedded in the neuroscience ICU at a large academic teaching hospital in Upstate New York.
      • The involvement of the PC NP dedicated to this service increased exposure and improved understanding of the philosophy and services available from PC to the provider teams, nursing, and other interdisciplinary services. The increase in consults, family meetings, and follow-up visits demonstrated the significant impact of this addition to the neuroscience ICU patient population.

      Abstract

      Palliative care is a service that works together with the patient’s primary team in an inpatient setting to provide additional guidance, support, and symptom management to patients dealing with a serious illness. Neuroscience intensive care unit patients are both complex and acute and often require multiple collaborating services to provide efficient and proper care. A palliative care nurse practitioner was embedded on the neuroscience ICU team; in doing so, the number of consults, family meetings, and follow-up visits increased. Multidisciplinary staff members had a better understanding of the role of palliative care. There were many benefits from the addition of a palliative care nurse practitioner.

      Keywords

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      Biography

      Kristin Soper, DNP, ANP-BC, AOCNP, is oncology nurse practitioner and an interim e director of nursing at SUNY Upstate Medical University in Syracuse, NY, and can be contacted at [email protected]

      Biography

      Maura Reilly, MS, FNP-C ACHPN, is a palliative care nurse practitioner, Neuroscience Intensive Care at SUNY Upstate Medical University.

      Biography

      Barbara Krenzer, MD, is a palliative care physician at SUNY Upstate Medical University.