CAPC, interrater reliability, primary assessment



  1. Andersen, Angela DNP, ACNP
  2. Tracy, Mary PhD, RN
  3. Nailon, Regina PhD, RN
  4. Gaster, Sue Ann BSN, RN
  5. Mooberry, Rachael BSN, RN
  6. Meza, Jane PhD


Early identification of palliative care needs in hospitalized patients is essential for clinicians to provide timely and effective interventions at the specific level of palliative care required by the patient and their family. The Center to Advance Palliative Care (CAPC) developed criteria to identify patients at hospital admission that are appropriate to receive primary palliative care assessment. No study has examined the reliability of CAPC criteria. A retrospective, descriptive, exploratory study design allowed for examination of the interrater reliability of CAPC criteria to identify palliative care needs in patients at hospital admission. Nurse investigators independently reviewed medical records of 100 randomly selected patients admitted to oncology and progressive care units who received palliative care. Interrater reliability was examined with the [kappa] statistic, along with a 95% confidence interval. The nurse investigators had perfect to substantial agreement for the majority of CAPC criteria. Study findings suggest it is realistic and suitable for nurses to administer and score CAPC criteria at hospital admission. Implementation of an instrument found to have reliability among users to trigger primary palliative care assessment at hospital admission will provide the structure and process needed to ensure consistent identification of patients at risk for having unmet palliative care needs.