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Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
128
Scripted Nurse Visits: A Resource-Efficient Palliative Care Model for Ventricular Assist Devices.
Nina R O'Connor1, Mary E Moyer1, James N Kirkpatrick2
11 Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.
Journal of Palliative Medicine
|July 12, 2016
Summary
Nurses can conduct scripted palliative care visits for patients receiving a ventricular assist device (VAD), meeting Centers for Medicare Services (CMS) requirements. This approach is feasible and acceptable, offering an alternative to full palliative care consults.
Area of Science:
- Palliative Care
- Cardiology
- Health Services Research
Background:
- The Center for Medicare Services (CMS) mandates palliative care for destination therapy ventricular assist device (VAD) recipients.
- Limited palliative care resources necessitate innovative solutions to meet this requirement.
Purpose of the Study:
- To assess a novel program using nurses for pre-VAD visits to facilitate advance care planning.
- To evaluate the triage of patients needing full palliative care consultations.
Main Methods:
- A prospective pilot study involved patients evaluated for VAD implantation.
- A registered nurse with basic palliative care training conducted scripted pre-VAD visits.
- Data collected on intervention feasibility, acceptability, need for consults, and patient outcomes.
Main Results:
- 37 pre-VAD visits were conducted between September 2014 and November 2015; 30 patients received a VAD.
- All patients completed the nurse visit; 6 required a full palliative care consult for symptom management, psychosocial distress, or goals of care.
- Patients prioritized discussing overarching values over specific medical interventions.
Conclusions:
- Nurses with basic palliative care training can effectively conduct scripted preparedness planning conversations.
- These nurse-led conversations meet CMS requirements, are well-received by patients, and serve as a viable alternative for resource-limited settings.
- Further research is recommended to compare outcomes of nurse visits versus traditional palliative care consults.
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