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Background: Despite the increased awareness of social determinants of health (SDoH), integrating social needs screening into health care practice has not consistently occurred. Local Problem: No social needs screening using recommended standardized questions was available at an outpatient hemodialysis clinic. Methods: Plan-Do-Study-Act cycles, based on the Model for Improvement, were used to implement the Core 5 SDoH screening tool, a staff referral process, and an evaluation of the implementation process. Intervention: A standardized social needs screening tool and a staff referral process were implemented. An evaluation of the implementation process also occurred. Results: Of 73 patients screened, 21 reported 32 unmet social needs; all received referrals to community resources. Nurses demonstrated high acceptance and usability of the tool and the referral process. Conclusions: Implementing a standardized screening and referral process customized to clinical workflow enhanced the identification of social needs in patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) is an essential component of quality palliative care that requires expert communication skills. Nurses are often the health care provider patients and families rely on when exploring their values and preferences and making treatment decisions. Therefore, communication and ACP was one of the 3 areas of practice addressed during the Palliative Nursing Summit. This article summarizes patient outcomes and nursing actions recommended by summit participants related to communication and ACP. Areas addressed included education, clinical care, research, and policy/regulation. Recommended patient outcomes included the honoring of patient/family preferences and the inclusion of ACP discussions during routine care and across the life span. Recommended nursing actions included the following: (1) nursing education (both undergraduates and practicing nurses) and competencies related to communication and ACP be developed and implemented; (2) primary palliative care, including communication and ACP, be included in the practice standards of all nursing specialties; (3) health care systems support conversations about ACP and related documentation; (4) research be conducted related to the implementation of patient/family preferences and related health care utilization; and (5) regulation and reimbursement be crafted to support nursing practice related to ACP and related conversations at the nurses' full level of expertise. [ABSTRACT FROM AUTHOR]