Intensive care unit (ICU) palliative care: percent of 4-hour intervals (on Day Zero and Day One of ICU admission) for which the documented pain score was less than or equal to 3.
SOURCE(S) VHA Inc. TICU care and communication bundle: care and communication quality measures. Irving (TX): VHA Inc.; 2006 Sep 15. 8 p.
DESCRIPTION
This measure is used to assess the percent of 4-hour intervals (on Day Zero and Day One of intensive care unit [ICU] admission) for which the documented pain score was less than or equal to 3 on a scale of 0-10.
RATIONALE
Palliative care focuses on prevention and relief of suffering, improving communication, promoting concordance between treatment and individual preferences, and facilitating transitions across care settings for patients with life threatening illness and their families. As such, it is increasingly accepted as an integral component of comprehensive intensive care unit (ICU) care for all critically ill patients, including those pursuing every reasonable treatment to prolong life. At the same time, evidence has accumulated that the quality of ICU palliative care needs improvement: patients experience high levels of pain and other distressing symptoms; families fail to understand basic information about diagnosis, prognosis, or critical care treatments and experience high levels of depression and anxiety; care plans diverge from patients' and families' preferences; and conflict among ICU clinicians, patients, and families is common.
The Institute of Medicine identified improvement of palliative care in the ICU and other care settings as a national health priority. For all healthcare providers and fields, it has also prioritized "closing the gap" between the current knowledge of optimal care and current clinical practice.
This measure is one of ten measures included in a palliative care bundle intended to close the "quality gap" between existing best evidence and current daily practice.
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