• Login
    View Item 
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) / Master Scholarly Projects
    • View Item
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) / Master Scholarly Projects
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Implementation of NECPAL and Chronic Liver Disease Screening Tools in Transplant Unit

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    Gaines_NecesidadesPaliativasSc ...
    Size:
    1.111Mb
    Format:
    PDF
    Download
    Author
    Gaines, Susanne
    Advisor
    Satyshur, Rosemarie D.
    Date
    2020-05
    Type
    DNP Project
    
    Metadata
    Show full item record
    Abstract
    Problem & Purpose: Liver disease is often associated with high symptom burden and long hospital course, subsequently leading to decreased quality of life. For patients considered unsuitable for transplantation, the alternative treatment options are supportive management and palliative care (PC). The most significant barrier to early PC is the failure to identify patients who may benefit. Currently, transplant health care professionals have limited PC education, as well as understanding of primary PC and PC service flow. The purpose of this quality improvement (QI) project is to identify non-transplantable liver disease patients’ unidentified unmet PC needs, utilizing two validated tools (Necesidades Paliativas [Palliative. Needs]) (NECPAL) and Chronic Liver Disease Questionnaire (CLDQ), and integrate them within routine nursing care activities in the transplant unit. Method: This DNP project was integrated into a Quality Improvement (QI) project guided by the MAP-IT (Mobilize-Assess-Plan-Implement-Track) QI process model. Over a 12-week period, nurses and nurse practitioners (NPs) completed the tools for every non-transplantable liver disease patient. The NECPAL screening tool was used to identify patients in need of PC, and was completed by the NPs. The CLDQ tool was completed by the bedside nurse and was used to assist with identifying symptoms and quality of life. Results: A total of five nurse practitioners and ten staff nurses received education and training on the NECPAL and CLDQ tools from the DNP student project leader. Sixteen non-transplant liver disease patients ages ranging 29 to 68, median age 52, majority (69%) female participated. Percentage of patients who completed the CLDQ and reported symptoms of unmet needs an average of 80%. The most symptoms reported were abdominal bloating and discomfort, worry, and family impact. The percentage of both screening tools goal 100% average (50%, n=9) were completed by the nurses and NPs. The percentage of patients completing the NECPAL an average of 60%, indicated a need for integration of palliative care. The unintended barriers included change in medical director, nurses completing one of the two screening tools, and patients deeming nontransplantable on the transplant service admitted to other units. Conclusions: Implementation of NECPAL and CLDQ tools identified multiple unmet PC needs in non-transplantable liver disease patients. Nurses and nurse practitioners voiced confidence and ease in use of the tools identifying symptoms and clinical indicators for the identification of unmet palliative care needs and to promote incorporation into routine nursing care in liver disease patients who were deemed non-transplantable.
    Keyword
    Chronic Liver Disease Questionnaire (CLDQ)
    Necesidades Paliativas (NECPAL)
    End State Liver Disease
    Palliative Care
    Patient Satisfaction
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/12955
    Collections
    Doctor of Nursing Practice (DNP) / Master Scholarly Projects

    entitlement

     
    DSpace software (copyright © 2002 - 2021)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.