Keywords

methodology, nursing research, palliative care, structure and process

 

Authors

  1. Chovan, John D. PhD, DNP, RN, CNP, CNS, PMHNP-BC, PMHCNS-BC, ACHPN, AHN-BC
  2. Warren, Barbara J. PhD, RN, CNS, PMHCNS-BC, FAAN
  3. Menke, Edna PhD, RN
  4. Barker, Elizabeth PhD, RN, CNP, FNP-BC, FAANP, FACHE

Abstract

The purpose of this project was to evaluate the structures and processes of an inpatient palliative care consultation service in light of national guidelines developed by the National Consensus Project for Quality Clinical Palliative Care. The project was a cross-sectional case study of the views of the members of the palliative care team with respect to the appropriateness, presence, degree of implementation, and priority for attending to 39 criteria of Domain I: Structure and Processes of the National Consensus Project for Quality Palliative Care guidelines. Demographic and evaluative data were collected from the team using a modified form of an existing questionnaire. After the data from the questionnaire were analyzed, a focus group interview was held to explicate the group's thoughts about items the group indicated as high priority. The content of the transcript was analyzed to uncover recommendations for structure and process improvement and other issues to improve service. Seven of eight participants returned questionnaires, and five of eight participants attended the focus group. Of the 39 criteria, 38 were deemed appropriate to the service, and of those, 32 were already present in the evaluated palliative care service. Twenty-seven recommendations were developed for implementing or improving 15 high-priority criteria. The alignment of the evaluated service with the consensus-based criteria was determined as was the direction needed to bring the service into full compliance. This project also demonstrated a methodology that is useful for program evaluation of palliative care inpatient consultation services. Implications for the nursing profession, including nursing education, and the evaluation of inpatient palliative care consultation services are discussed.