Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams
Background: Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could bene...
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| Veröffentlicht in: | American journal of hospice & palliative medicine 2017-05, Vol.34 (4), p.330-334 |
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| container_issue | 4 |
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| container_title | American journal of hospice & palliative medicine |
| container_volume | 34 |
| creator | O’Mahony, Sean Johnson, Tricia J. Amer, Shawn McHugh, Marlene E. McHenry, Janet Fosler, Laura Kvetan, Vladimir |
| description | Background:
Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service.
Objective:
To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center.
Methods:
The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests.
Results:
Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different.
Conclusion:
Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant. |
| doi_str_mv | 10.1177/1049909115627425 |
| format | Article |
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Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service.
Objective:
To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center.
Methods:
The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests.
Results:
Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different.
Conclusion:
Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.</description><identifier>ISSN: 1049-9091</identifier><identifier>EISSN: 1938-2715</identifier><identifier>DOI: 10.1177/1049909115627425</identifier><identifier>PMID: 26917789</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Advanced Practice Nursing - economics ; Advanced Practice Nursing - organization & administration ; Aged ; Cooperative Behavior ; Female ; Hospital Costs - statistics & numerical data ; Humans ; Intensive Care Units - economics ; Intensive Care Units - organization & administration ; Male ; Middle Aged ; Nursing ; Palliative Care - economics ; Palliative Care - organization & administration ; Patient Care Team - organization & administration</subject><ispartof>American journal of hospice & palliative medicine, 2017-05, Vol.34 (4), p.330-334</ispartof><rights>The Author(s) 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-b17e9ee2b21c4053e4839f8c3cbd7847d7ebad963c311d77fd00f42f8ec6fcb83</citedby><cites>FETCH-LOGICAL-c370t-b17e9ee2b21c4053e4839f8c3cbd7847d7ebad963c311d77fd00f42f8ec6fcb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1049909115627425$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1049909115627425$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26917789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O’Mahony, Sean</creatorcontrib><creatorcontrib>Johnson, Tricia J.</creatorcontrib><creatorcontrib>Amer, Shawn</creatorcontrib><creatorcontrib>McHugh, Marlene E.</creatorcontrib><creatorcontrib>McHenry, Janet</creatorcontrib><creatorcontrib>Fosler, Laura</creatorcontrib><creatorcontrib>Kvetan, Vladimir</creatorcontrib><title>Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams</title><title>American journal of hospice & palliative medicine</title><addtitle>Am J Hosp Palliat Care</addtitle><description>Background:
Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service.
Objective:
To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center.
Methods:
The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests.
Results:
Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different.
Conclusion:
Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.</description><subject>Advanced Practice Nursing - economics</subject><subject>Advanced Practice Nursing - organization & administration</subject><subject>Aged</subject><subject>Cooperative Behavior</subject><subject>Female</subject><subject>Hospital Costs - statistics & numerical data</subject><subject>Humans</subject><subject>Intensive Care Units - economics</subject><subject>Intensive Care Units - organization & administration</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nursing</subject><subject>Palliative Care - economics</subject><subject>Palliative Care - organization & administration</subject><subject>Patient Care Team - organization & administration</subject><issn>1049-9091</issn><issn>1938-2715</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkDtPwzAURi0EoqWwMyGPLAG_EttjVfGoVEGHljVynJsqVR7FTirx73HU0gEJsfihe75PugehW0oeKJXykRKhNdGUxgmTgsVnaEw1VxGTND4P7zCOhvkIXXm_JYQzIeglGrFEh7jSY_QxbzrYONOVbYPbAi9NVZXhtwc8Mw7wNN-bxkKOl87YrrSA33rnweOQa4cDGn-C103Z4RWY2l-ji8JUHm6O9wStn59Ws9do8f4yn00XkeWSdFFGJWgAljFqBYk5CMV1oSy3WS6VkLmEzOQ64ZZTmktZ5IQUghUKbFLYTPEJuj_07lz72YPv0rr0FqrKNND2PqXD9omSkv2PKpYksQxqAkoOqHWt9w6KdOfK2rivlJJ0EJ_-Fh8id8f2PqshPwV-TAcgOgDebCDdtr1rgpi_C78BKxuKKA</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>O’Mahony, Sean</creator><creator>Johnson, Tricia J.</creator><creator>Amer, Shawn</creator><creator>McHugh, Marlene E.</creator><creator>McHenry, Janet</creator><creator>Fosler, Laura</creator><creator>Kvetan, Vladimir</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201705</creationdate><title>Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams</title><author>O’Mahony, Sean ; Johnson, Tricia J. ; Amer, Shawn ; McHugh, Marlene E. ; McHenry, Janet ; Fosler, Laura ; Kvetan, Vladimir</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-b17e9ee2b21c4053e4839f8c3cbd7847d7ebad963c311d77fd00f42f8ec6fcb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Advanced Practice Nursing - economics</topic><topic>Advanced Practice Nursing - organization & administration</topic><topic>Aged</topic><topic>Cooperative Behavior</topic><topic>Female</topic><topic>Hospital Costs - statistics & numerical data</topic><topic>Humans</topic><topic>Intensive Care Units - economics</topic><topic>Intensive Care Units - organization & administration</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nursing</topic><topic>Palliative Care - economics</topic><topic>Palliative Care - organization & administration</topic><topic>Patient Care Team - organization & administration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Mahony, Sean</creatorcontrib><creatorcontrib>Johnson, Tricia J.</creatorcontrib><creatorcontrib>Amer, Shawn</creatorcontrib><creatorcontrib>McHugh, Marlene E.</creatorcontrib><creatorcontrib>McHenry, Janet</creatorcontrib><creatorcontrib>Fosler, Laura</creatorcontrib><creatorcontrib>Kvetan, Vladimir</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>American journal of hospice & palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Mahony, Sean</au><au>Johnson, Tricia J.</au><au>Amer, Shawn</au><au>McHugh, Marlene E.</au><au>McHenry, Janet</au><au>Fosler, Laura</au><au>Kvetan, Vladimir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams</atitle><jtitle>American journal of hospice & palliative medicine</jtitle><addtitle>Am J Hosp Palliat Care</addtitle><date>2017-05</date><risdate>2017</risdate><volume>34</volume><issue>4</issue><spage>330</spage><epage>334</epage><pages>330-334</pages><issn>1049-9091</issn><eissn>1938-2715</eissn><abstract>Background:
Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service.
Objective:
To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center.
Methods:
The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests.
Results:
Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different.
Conclusion:
Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>26917789</pmid><doi>10.1177/1049909115627425</doi><tpages>5</tpages></addata></record> |
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| ispartof | American journal of hospice & palliative medicine, 2017-05, Vol.34 (4), p.330-334 |
| issn | 1049-9091 1938-2715 |
| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Advanced Practice Nursing - economics Advanced Practice Nursing - organization & administration Aged Cooperative Behavior Female Hospital Costs - statistics & numerical data Humans Intensive Care Units - economics Intensive Care Units - organization & administration Male Middle Aged Nursing Palliative Care - economics Palliative Care - organization & administration Patient Care Team - organization & administration |
| title | Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams |
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