The integration of palliative care within the Intensive Care Unit (ICU) setting is crucial for ensuring comprehensive patient care that addresses not only physical needs but also emotional and spiritual well-being. To support healthcare professionals in this endeavor, the Center to Advance Palliative Care (CAPC) offers a range of valuable tools and resources designed to facilitate effective palliative care screening and implementation in the ICU.
These resources are specifically tailored to assist both palliative care and ICU teams in several key areas: assessing patient needs, conducting family meetings to align care priorities, and delivering essential palliative services within the demanding ICU environment. By utilizing these tools, healthcare providers can proactively identify patients who would benefit from palliative care, thereby enhancing their quality of life and ensuring their wishes are honored during critical illness.
One essential resource provided is the “Implementing ICU Screening Criteria for Unmet Palliative Care Needs: A Guide for ICU and Palliative Care Staff.” This guide offers practical direction on needs assessment, selection of appropriate screening criteria, implementation planning, and ongoing evaluation. It serves as a roadmap for healthcare teams looking to systematically integrate palliative care screening into their ICU protocols.
To further support clinical practice, CAPC also provides templates for progress notes in critical care settings. The “Critical Care Progress Note Template,” shared by Northwell Health, offers a structured format for documenting patient progress and care plans. Similarly, the “Family Conference Progress Note,” contributed by Froedert Hospital and the Medical College of Wisconsin, aids ED staff in documenting important family meetings, ensuring clear communication and shared decision-making.
Effective communication with families is paramount in palliative care. The “Family Goal-Setting Conference,” a 10-step guide from Mount Sinai Hospital, provides recommended phrases and a structured approach for clinical teams to navigate these sensitive conversations. Complementing this, “A Guide for Conducting an ICU Family Meeting When the Patient Is Unable to Participate” offers a communication framework specifically designed for discussing goals of care with families when the patient cannot directly participate.
Addressing end-of-life care in the ICU requires careful protocols, particularly concerning mechanical ventilation. Resources like “Removal of Mechanical Ventilation” and the “Withdrawal of Mechanical Ventilation Protocol for the Dying Patient,” both shared by Froedert Hospital, offer guidance on compassionate and ethical approaches to these complex situations. The latter protocol specifically focuses on a process for removing mechanical ventilation when death is the expected outcome, ensuring patient comfort and dignity.
For institutions seeking to formalize palliative care screening within their ICUs, the “Policy: Screening In the ICU,” a sample policy from Mount Carmel Health, provides a valuable starting point. This resource offers a template for developing internal policies for palliative screening and assessment conducted by ICU staff.
Finally, for the specialized context of neuro-ICUs, “Palliative Care in the Neuro-ICU: The Crystal Ball of Prognosis” offers crucial insights into the strategies and limitations of prognostication for neurocritically ill patients. This resource, available as a recorded webinar, highlights the unique challenges and considerations in providing palliative care within this specific ICU setting.
By leveraging these resources from the Center to Advance Palliative Care, ICU and palliative care teams can significantly enhance their ability to screen for palliative care needs, facilitate meaningful family discussions, and deliver patient-centered care that prioritizes comfort, dignity, and quality of life throughout the ICU journey.
