Date of Award
2024
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Nilsa Black-Mead
Committee Member
Haley Hoy
Committee Member
Mandy Bradshaw
Subject(s)
Lungs--Obstructive diseases, Palliative treatment--Utilization
Abstract
There are 251 million people diagnosed with chronic obstructive pulmonary disease (COPD) and 3.3 million deaths annually linked to disease-related complications. Palliative care is an underutilized resource for a patient with COPD. It can help establish goals of care, manage disease-related symptoms, and improve quality of life. Rural hospitals often face barriers to accessing palliative care services, including a lack of healthcare providers, means of transportation, and stigma surrounding the holistic health model. This DNP project aimed to generate appropriate community-initiated palliative care referrals to increase service uptake and reduce readmissions within 30 days of discharge. Patients with COPD who were 55 years and older were screened using the Palliative Care Screening Tool to determine if the patient met criteria for a palliative care referral. The project was implemented on a 30-bed medical-surgical unit in an 80-bed rural hospital in the Panhandle of Florida. The clinical practice change project set new unit protocols to determine if appropriate palliative care referrals increase the uptake of community-initiated palliative care services. Registered nurses and unit case managers used evidence-based practices to screen and identify appropriate palliative care referrals using the Palliative Care Screening Tool to initiate community-based referrals and increase the uptake of palliative care services to reduce the number of patients with COPD who present to the emergency department for disease-specific care. Following the implementation, the uptake of community-based palliative care services decreased readmissions within 30 days of discharge for an acute COPD exacerbation. During the implementation of the clinical practice change, readmissions for patients with COPD within 30 days of discharge declined by 13%. Since readmissions remain a huge concern for healthcare organizations, incorporating a tool to assess the need for palliative care could catalyze the improvement of quality care for patients with chronic illnesses in rural communities.
Recommended Citation
Lofton, Corey B., "Increasing the uptake of palliative care for patients with COPD through community-based referrals : a clinical practice change" (2024). Doctor of Nursing Practice (DNP). 80.
https://louis.uah.edu/uah-dnp/80