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Integrative Review for Identifying Patients Appropriate for End-of-Life Care Interventions by

Background: End of life is defined as the last 12 months before a person dies, with 1% of the total population passing each year. Primary care providers can predict end of life and implement interventions. Early identification of patients for palliative care prevents crises, meets the needs of patients and families, and reduces the cost of healthcare. Screening for end-of-life care needs in primary care using the Gold Standards Framework (GSF) and the Prognostic Indicator Guidance (PIG) tool/surprise question will minimize risk of missed interventional opportunities. Purpose: This educational intervention served to increase provider knowledge of the GSF and PIG, and supplied providers with resources for screening patients for end-of-life care needs. Presentation and Toolkit: An educational presentation of this integrative review and resource packet was given to providers and staff in a primary care clinic. The packet contained current evidence, statistics, references, and resources available for patients and providers. The DNP student created an end-of-life care screening algorithm and an adapted screening tool, both of which were embedded in the resource packet. Outcomes/Discussion: The DNP student successfully met the desired outcomes. Pre- (100%) and post-presentation (73%) surveys revealed a 100% increase in provider knowledge regarding the GSF, PIG, surprise question, and available resources. Respondents (100%) said they would use the packet and felt confident doing so. The algorithm was deemed helpful, easy to use and satisfied the providers desire for guidance in this process. Implications/Conclusion: Implications for future practice include the effective and efficient use of the resource packet for early identification of end-of-life patients in primary care. The DNP student is available to consult and assist with implementation of the packet into practice. Keywords: Gold Standards Framework, palliative care, end of life, surprise question
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