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Impact of a Palliative Care Nurse Practitioner in an Oncology Clinic: A Quality Improvement Effort.
D'Ambruoso, Sarah F; Glaspy, John A; Hurvitz, Sara A; Wenger, Neil S; Pietras, Christopher; Ahmed, Kauser; Drakaki, Alexandra; Goldman, Jonathan Wade; Anand, Sidharth; Simon, Wendy; Kung, Jennie; Coscarelli, Anne; Rosen, Lee S; Peddi, Parvin F; Wong, Deborah J L; Santos, Katherine; Phung, Peter; Karlin, Daniel; Walling, Anne M.
Afiliação
  • D'Ambruoso SF; Department of Medicine, University of California, Los Angeles, CA.
  • Glaspy JA; Department of Medicine, University of California, Los Angeles, CA.
  • Hurvitz SA; Department of Medicine, University of California, Los Angeles, CA.
  • Wenger NS; Department of Medicine, University of California, Los Angeles, CA.
  • Pietras C; Department of Medicine, University of California, Los Angeles, CA.
  • Ahmed K; Simms/Mann-UCLA Center for Integrative Oncology, Los Angeles, CA.
  • Drakaki A; Department of Medicine, University of California, Los Angeles, CA.
  • Goldman JW; Department of Medicine, University of California, Los Angeles, CA.
  • Anand S; Department of Medicine, University of California, Los Angeles, CA.
  • Simon W; Department of Medicine, University of California, Los Angeles, CA.
  • Kung J; Hospital Operations, University of California, Los Angeles, CA.
  • Coscarelli A; Department of Medicine, University of California, Los Angeles, CA.
  • Rosen LS; Department of Medicine, University of California, Los Angeles, CA.
  • Peddi PF; Department of Medicine, University of California, Los Angeles, CA.
  • Wong DJL; Department of Medicine, University of California, Los Angeles, CA.
  • Santos K; Department of Medicine, University of California, Los Angeles, CA.
  • Phung P; Department of Medicine, University of California, Los Angeles, CA.
  • Karlin D; Department of Medicine, University of California, Los Angeles, CA.
  • Walling AM; Department of Medicine, University of California, Los Angeles, CA.
JCO Oncol Pract ; 18(4): e484-e494, 2022 04.
Article em En | MEDLINE | ID: mdl-34748398
ABSTRACT

PURPOSE:

Guidelines support early integration of palliative care (PC) into standard oncology practice; however, little is known as to whether outcomes can be improved by modifying health care delivery in a real-world setting.

METHODS:

We report our 6-year experience of embedding a nurse practitioner in an oncology clinic (March 2014-March 2020) to integrate early, concurrent advance care planning and PC.

RESULTS:

Compared with patients with advanced cancer not enrolled in the palliative care nurse practitioner program, in March 2020, patients who are enrolled are more likely to have higher quality of PC (eg, goals of care note documentation [82% v 15%; P < .01], referral to the psychosocial oncology program [67% v 37%; P < .01], and referral to hospice [61% v 34%; P < .01]) and less inpatient utilization in the last 6 months of life (eg, hospital days [12 v 18; P < .01] and intensive care unit days [1.2 v 2.3; P < .01]). The program expanded over time with the support of faculty skills training for advance care planning and PC, supporting a shared mental model of PC delivery within the oncology clinic.

CONCLUSION:

Embedding a trained palliative care nurse practitioner in oncology clinics to deliver early integrated PC can lead to improved quality of care for patients with advanced cancer.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias / Profissionais de Enfermagem Tipo de estudo: Guideline Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias / Profissionais de Enfermagem Tipo de estudo: Guideline Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article