Analysis of quality palliative care in a specialized medicine setting: an observational study

BACKGROUND: Recently health economic expenditure has increased considerably determining an increased awareness of excessive use of "low-value care" treatments, especially for chronic-degenerative diseases. AIM: Describing Quality of life (QoL) of patients and palliative care's skills of nurses in internal medicine unit. METHODS: Observational study conducted in an internal medicine unit that admit patients with chronic critical illness. Patients' QoL was measured with the integrated Palliative Care Outcome Scale (IPOS), and nursing staff skills regarding palliative care with the Questionnaire of Professional Skills Nurses in Palliative Care (QVPICP). IPOS was administered at admission and one week later. RESULTS: All the patients (n=13) accepted to participate to the study (mean age 80 years; SD  15). Eight (61%) were female. All the nurses invited (n=17) completed the QCPICP. Most of them was female (70%). The mean age was 40 years SD  14. Nurses perceived they have skills, knowledge, and abilities to approach patient's palliative care path (mean QVPICP: 7). IPOS means scores were worse in the following variables: pain (before: 3; after: 4); lack of mobility (before: 3; after: 4); sleepiness (before: 3; after: 4); depression (before: 3; after: 4). CONCLUSION: Patient's QoL showed a worsening in the after assessment. Although nurses perceived themselves skilled in taking care of patients with palliative care needs, organizations may not allow nurses to perform their role to the best of their competencies. NURSING IMPLICATION: Team briefing and debriefings in internal medicine unit may promote a holistic approach aimed at improving patients' QoL.