Intensive Care Patients Need Better Access to
Palliative Care Says National Organization
National Hospice and Palliative Care Organization
issues six step call for action
Sept.
4, 2008 More than 20 percent of deaths in the U.S. occur during or
following admission to an Intensive Care Unit, but these patients do not
have adequate access to palliative care and the National Hospice and
Palliative Care Organization wants that to change.
The NHPCO has issued a position statement calling
for increased access to palliative care for patients in all critical
care settings.
At this critical time, palliative care providers
can complement the knowledge and skills of critical care professionals
in the areas of symptom management, assistance with decision making, and
end-of-life care, according to a news release from NHPCO.
There are times when a given technology is not
achieving the hoped-for benefit or is too difficult for the patient to
continue.
Additionally, according to NHPCO, patients
overwhelmed with symptoms such as pain, difficulty breathing, or
confusion, and families of patients in the ICU must oftentimes address
difficult medical decisions. These individuals would all benefit from
the availability of palliative care.
"The focus of critical care is primarily to saves
lives," says J. Donald Schumacher, NHPCO president and CEO.
"This is not always possible not because of any
lack of excellence on the part of critical care physicians, nurses, and
others, but because some patients' diseases are too advanced or their
injuries are too severe. There are times when patients need additional
care and support. They need palliative care."
NHPCO determined that there was sufficient concern
related to the provision of palliative services in critical care
settings to warrant the statement and call to action. Created by the
organization's Ethics Committee, it was approved by NHPCO leadership and
is available on the organization's Web site.
Strengthening access to palliative care in all
critical care settings and promoting collaboration among all who are
involved in this effort are the goals of NHPCO's call to action.
Palliative
care is defined as patient and family centered care that
optimizes quality of life by anticipating, preventing, and
treating suffering. Palliative care throughout the continuum of
illness involves addressing physical, intellectual, emotional,
social, and spiritual needs and facilitating patient autonomy,
access to information, and choice
Call to Action:
1. All eligible patients should have access to
palliative care services.
2. Every critical care health care provider should
review the National Consensus Project/National Quality Forum (NCP/NQF)
guidelines for palliative care and hospice.
3. Every health care system should adopt the
preferred practices as they apply in the critical care setting.
4. Every critical care health care provider should
be educated in the principles of palliative care.
5. Current evidence-based practices related to
palliative care should be used in the treatment of patients.
6. Palliative care services within critical care
must be evaluated using an accepted continuous quality improvement
methodology.
As the statement was developed, the document was
shared with colleagues working with the Center to Advance Palliative
Care, the Hospice and Palliative Nurses Association, and the Society of
Critical Care Medicine.
Hospice and palliative providers are encouraged to
utilize the document as they partner with critical care providers.
Sept.
4, 2008 More than 20 percent of deaths in the U.S. occur during or
following admission to an Intensive Care Unit, but these patients do not
have adequate access to palliative care and the National Hospice and
Palliative Care Organization wants that to change.