The ‘Surprise Question’ and heart failure: Can it identify patients with unmet palliative care needs? A Pilot Study Protocol.
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All Authors
Burgess, Ruth
McGinlay, Mel
Ziegler, Lucy
Straw, Sam
LTHT Author
Burgess, Ruth
McGinlay, Mel
McGinlay, Mel
LTHT Department
Research & Innovation
Cardio-Respiratory
Cardiology
Cardio-Respiratory
Cardiology
Non Medic
Research Nurse
Heart Failure Nurse Specialist
Heart Failure Nurse Specialist
Publication Date
2025
Item Type
Conference Abstract
Language
Subject
Subject Headings
Abstract
Background:
Patients with chronic heart failure live with symptoms such as breathlessness, fatigue, and fluid retention, with a symptom burden comparable to many forms of cancer (1). The purpose of palliative care is to improve the quality of life for patients with life-limiting illness and their families by assessing and treating physical, psychological, social, and spiritual problems (2). The benefits of palliative care take time and its early integration in heart failure is recommended by guidelines (3). Despite this, few heart failure patients are referred to palliative care in a timely manner (4), a finding replicated in a recent audit. Specialist Heart Failure Nurses when asked the ‘Surprise Question’ can predict which patients are approaching the end-of-life (5).
Aims:
When posed to Specialist Heart Failure Nurses, does a ‘no’ response to the Surprise Question identify heart failure patients with unmet palliative care needs?
Methods:
Patients admitted with heart failure will be invited to participate in the study. The Surprise Question – “Would you be surprised if this patient were to die in the next twelve months?” – will be posed to Specialist Heart Failure Nurses and the response recorded. We will assess the palliative care needs of patients using a validated tool: Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF). Data will be analysed to assess the burden of unmet needs in relation to the Surprise Question response.
Results and conclusions:
The findings of this study will provide pilot data for further research which aims to test whether routinely posing the Surprise Question improves early assessment of palliative care needs, early referral to specialist palliative care services and additional support for patients and their families. Our aspiration is to improve the quality of life for heart failure patients and their families as they approach the final months of life.