부산대학교 도서관

1. Upon successful completion, participants will self-report the ability to describe a nurse-led embedded palliative care model within a pulmonary practice serving rural communities. 2. Upon successful completion, participants will self-report the ability to utilize the results of the 10-year reflection to promote primary palliative care skills into clinical practice. Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), are among the leading causes of morbidity and mortality worldwide. Limited access to palliative care contributes to worsening outcomes for those diagnosed with these conditions. In order to address this gap in care, a nurse-led embedded palliative care model (ePC) was implemented to improve the quality of life for patients while working to expand the primary palliative skills of the pulmonary teams through coaching and mentoring. This quality improvement (QI) project involved embedding a board-certified palliative care nurse practitioner within an existing pulmonary practice to see patients and build primary palliative care skills of the pulmonary team. This presentation will focus specifically on the teams' reflection of a decade of delivery of this small-scale palliative care model. Utilizing the Plan-Do-Act-Study model, the team continuously engaged in dialogue on key elements of the ePC model: 1) the process of palliative care referrals, 2) expectations of the pulmonary and palliative team, 3) existing and needed pulmonary and primary palliative skills, and 4) strategies for enhancing access to secondary palliative care. The ideal method for referral was using real-time, face-to-face introductions of the palliative provider to the patient by the pulmonary team. Ongoing advocacy for palliative care, with explicit statements differentiating it hospice, reduced the incidence of missed appointment by patients. Bidirectional skill-sharing was necessary between the pulmonary and palliative team members to address disease management and symptom burden. This QI project demonstrated an overwhelming acceptance and sustainability of an ePC model by pulmonary teams that can extend to other practices. The model provides a framework for ongoing access to specialty palliative care whilst coaching and mentoring pulmonary teams on symptom management and goals-of-care conversations. [ABSTRACT FROM AUTHOR]