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Integrating a Question Prompt List on an Inpatient Oncology Unit to Increase Prognostic Awareness.
Vicki C McLawhorn1, Joy Vess2, Bonnie P Dumas2
1Vidant Medical Center.
Clinical Journal of Oncology Nursing
|July 22, 2016
Summary
Implementing a patient-initiated discussion aid increased do-not-resuscitate (DNR) orders and hospice referrals for cancer patients. This improves prognostic awareness and facilitates end-of-life care discussions.
Area of Science:
- Oncology
- Palliative Care
- Medical Communication
Background:
- Many incurable cancer patients lack accurate prognosis understanding, leading to futile aggressive treatments.
- Enhanced prognostic awareness can facilitate earlier de-escalation of aggressive care.
Purpose of the Study:
- Introduce a patient-initiated discussion aid on an oncology unit to boost prognostic awareness.
- Promote patient-provider dialogue to guide end-of-life treatment decisions.
Main Methods:
- Retrospective review of medical records for patients with solid malignancies.
- Assessed rates of do-not-resuscitate (DNR) orders and hospice referrals before and after implementing a communication aid.
Main Results:
- Inclusion of the discussion aid correlated with an increase in active DNR orders.
- Hospice referrals also showed an increase following the aid's implementation.
Conclusions:
- Patient-initiated discussion aids can enhance prognostic awareness in oncology settings.
- These aids may facilitate important end-of-life care discussions and decisions.
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