Related Experiment Video
Updated: Jun 24, 2025
Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Improving Goal-Concordant Care in Intensive Care Unit Admissions from the Emergency Department in a Comprehensive
María T Cruz Carreras1, Nico Nortjé1, Emily Thompson1
1Department of Emergency Medicine (M.T.C.C., N.N., E.T., K.T., F.Z., N.R., M.G., S.A.H.), Department of Critical Care Medicine, Department of Integrated Ethics in Cancer Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Context:
As patients approach the end of life, discussion of their treatment goals is essential to avoid unnecessary suffering and deliver care in a manner consistent with their overall values.
Objectives:
Implement a multipronged approach to improve the rates of advance care planning (ACP) documentation among providers admitting patients with cancer to the intensive care unit (ICU) from the emergency department (ED).
Methods:
We developed multiple interventions including the development of a best-practice advisory to alert providers when patients had previous do-not-resuscitate orders; standardization of ACP documentation; early oncologist involvement in goals-of-care conversations with patients; a survey of ED providers to identify barriers to success; and positive reinforcement strategies aimed at improving the rates of ACP documentation in patients admitted from the ED to the ICU.
Results:
Prior to our interventions, only 13% of patients admitted to the ICU from the ED had ACP notes. This percentage increased to 90% by the last month of our project.
Conclusion:
Through our multipronged approach, we significantly improved the rates of ACP documentation among providers admitting patients from the ED to the ICU.
More Related Videos
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
09:49Dual-phase Cone-beam Computed Tomography to See, Reach, and Treat Hepatocellular Carcinoma during Drug-eluting Beads Transarterial Chemo-embolization
Published on: December 2, 2013
Related Concept Videos
01:21Planning Nursing Care I
01:13Patient-centered Care
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:21Cancer Survival Analysis
01:29Planning Nursing Care II