A Point Prevalence Study of Need and Provision of Palliative Care in Adult and Medical Surgical Inpatients

ABSTRACT

Aim

To gain an understanding of palliative care need and provision in adult medical and surgical inpatients.

Design

An observational point prevalence study was conducted across four study sites in Western Australia.

Methods

All data were collected directly from patient medical records by Registered Nurses. Potential palliative care need was assessed using disease-specific indicators for the 12 conditions outlined in the Gold Standards Framework Proactive Indicator Guidance.

Results

A total of 865 medical and surgical inpatients met study inclusion criteria. Across the four study sites, 38% (n = 331) of adult inpatients reviewed could have potentially benefitted from palliative care. Of the n = 331 patients assessed as having indicators for palliative care, there was evidence that 27% (n = 90) were currently receiving some form of palliative care, while 3% (n = 9) had been referred for specialist palliative care. For the majority of patients (70%, n = 232) there was no evidence of them receiving any form of palliative care or awaiting specialist palliative care.

Conclusion

This study identified high levels of potential palliative care need among adult medical and surgical inpatients. The majority of the patients identified as having indicators for palliative care were not receiving any form of palliative care.

Implications for the Profession and/or Patient Care

The high prevalence of palliative care need found in this study highlights that recognising and addressing palliative care is essential for high-quality care for medical and surgical inpatients. To address the high level of need identified all nurses require basic palliative care training to provide optimal patient care.

Impact

Knowledge about the level of palliative care need and provision of palliative care in public hospitals was limited. This study identified a high prevalence of potential palliative care need in medical and surgical inpatients. The majority of patients with indicators for palliative care were not receiving any form of palliative care. This research demonstrates that palliative care needs should be considered by all registered nurses and other health professionals caring for medical and surgical inpatients.

Reporting Method

The study is reported using the STROBE guidelines.

Patient or Public Contribution

No patient or public contribution.