A Bridge to Comfort: Nurses Driving Early Palliative Consults in the Intensive Care Unit

This project established a protocol that enabled all intensive care unit (ICU) patients to receive a palliative care (PC) screening. Those who met criteria received timely access to PC in the ICU setting. Delayed access to PC can result in untreated symptoms, lack of understanding of care preferences, unwanted invasive procedures, and underutilization of hospice care. A Plan-Do-Study-Act framework was utilized to establish this protocol. The multidisciplinary team sought to increase PC consults in the ICU by 30% using a nurse-driven standardized screening tool. The PC Referral Criteria established by the Center to Advance Palliative Care were used as a framework to establish the workflow/protocol. The outcome measures were the number of patients screened for PC on admission to the ICU, the number of PCs placed in the ICU, the number of code blues, and ICU staff satisfaction. PC consults increased by 163% (471) in 2024 and 143% (435) in 2025 as compared with 2023 (179). In 2023, there were 33 code blues in the ICU, and these decreased by 21% (26) in 2024 and 12% (29) in 2025. ICU staff (87%) felt that the PC screening process had a positive impact on staff and their practice.