Palliative Care Needs in the Neuro-ICU

Area of Science:

• Neurology
• Neurosurgery
• Critical Care Medicine
• Palliative Care

Background:

• Patients in neurological or neurosurgical intensive care units (ICUs) frequently have unmet palliative care needs.
• Identifying and addressing these needs is crucial for improving patient and family well-being.

Purpose of the Study:

• To develop and implement a palliative care needs screening tool for neuro-ICU patients.
• To assess the tool's effectiveness in identifying needs and influencing care actions.

Main Methods:

• A quality improvement project utilized a parallel-group prospective cohort design.
• A four-question screening tool was implemented daily on morning rounds for one neurocritical care service.
• The study compared outcomes between a service with screening and a control service without screening.

Main Results:

• Palliative care needs were identified in 62% of screened neuro-ICU patients.
• The most common needs were social support (53%) and establishing goals of care (28%).
• Screening was associated with a significant increase in documented family conferences (p=0.019) and a trend towards more palliative care consultations (p=0.056).

Conclusions:

• A brief palliative care needs screening tool effectively identified significant needs in neuro-ICU patients.
• The implementation of this tool was associated with actions to address identified needs, suggesting potential for improved patient and family care.
• This quality improvement initiative demonstrates the value of systematic screening for palliative care needs in critical care settings.