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Palliative Care in the Emergency room

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https://www.readbyqxmd.com/read/28489813/implementing-a-novel-model-for-hospice-and-palliative-care-in-the-emergency-department-an-experience-from-a-tertiary-medical-center-in-taiwan
#1
Tzu-Chieh Weng, Ya-Chun Yang, Ping-Jen Chen, Wen-Fu Kuo, Wei-Lin Wang, Ya-Ting Ke, Chien-Chin Hsu, Kao-Chang Lin, Chien-Cheng Huang, Hung-Jung Lin
Hospice and palliative care has been recognized as an essential part of emergency medicine; however, there is no consensus on the optimal model for the delivery of hospice and palliative care in the emergency department (ED). Therefore, we conducted a novel implementation in a tertiary medical center in Taiwan. In the preintervention period, we recruited a specialist for hospice and palliative medicine in the ED to lead our intervention. In the early stage of the intervention, starting on July 1, 2014, we encouraged and funded ED physicians and nurses to receive training for hospice and palliative medicine and residents of emergency medicine to rotate to the hospice ward...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28438589/specialty-palliative-care-consultations-for-nursing-home-residents-with-dementia
#2
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson
CONTEXT: U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. OBJECTIVES: To examine the value of expanded palliative care access for NH residents with moderate to very severe dementia. METHODS: We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate to very severe dementia, and deaths in 2006-2010...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28292824/hospice-enrollment-in-patients-with-advanced-heart-failure-decreases-acute-medical-service-utilization
#3
Cindi K Yim, Yolanda Barrón, Stanley Moore, Chris Murtaugh, Anuradha Lala, Melissa Aldridge, Nathan Goldstein, Laura P Gelfman
BACKGROUND: Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. METHODS AND RESULTS: We performed a descriptive analysis of Medicare fee-for-service beneficiaries, with at least one home health claim between July 1, 2009, and June 30, 2010, and at least 2 HF hospitalizations between July 1, 2009, and December 31, 2009, who subsequently enrolled in hospice between July 1, 2009, and December 31, 2009...
March 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28282256/new-evidence-on-end-of-life-hospital-utilization-for-enhanced-health-policy-and-services-planning
#4
Donna M Wilson, Ye Shen, Stephen Birch
BACKGROUND: Long-standing concern exists over hospital use by people near or at the end of life (EOL) related to the appropriateness, quality, and cost of care in hospital. It is widely believed that most people die in hospital after an escalation in hospital use over the last year of life. As most deaths in high-income countries are not sudden or unexpected, opportunities exist for planning compassionate, effective, and evidence-based EOL care. OBJECTIVE: Gain current population-based evidence for EOL health policy and services planning...
March 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28156494/embedding-palliative-care-pc-in-a-community-based-cancer-center-benefits-and-barriers
#5
John Weems, Robert D Siegel, Teresa N Bowen, Leigh Stinnett, Jennifer Ashley
153 Background: The importance of involving PC early in the disease process of oncology patients is well documented. Decreased symptom burden, increased quality of life, and extended survival are proven outcomes; however, the provision of PC has largely been limited to the acute care setting in most institutions. Bon Secours St. Francis Health System, a community based healthcare system in Greenville, South Carolina, opened a comprehensive cancer center in late 2014. Our established inpatient PC team began seeing outpatients at the cancer center shortly after its opening...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152918/using-information-technology-it-to-improve-communication-between-the-emergency-room-and-cancer-clinic
#6
Conrad B Falkson, Tara D Baetz
158 Background: A communication gap was identified at the Cancer Centre of Southeastern Ontario which resulted in oncologists at the cancer centre (CC) not consistently being informed when oncology patients (pt) were seen in the emergency room (ER). An automated IT notification system was developed to inform oncologists when their pt were seen in the ER. METHODS: Pt who had been seen within 60 days in the CC were considered active. An IT notification system linked active CC visits and ER visits...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152810/interdisciplinary-care-rounds-in-the-community-changing-the-paradigm-of-supportive-service-involvement-in-cancer-care
#7
Hal E Crosswell, Terra Dillard, Jennifer Bayne, Tina Redenz, Kyle Duggan, Angela Belew
83 Background: Although cancer centers have focused on optimizing seamless Multidisciplinary Care (MDC) at tumor boards and/or clinics, there has been little published on effective ways to involve supportive services into the management of cancer patients. Historically, supportive services have been initiated when there is an active need rather than in anticipation of that need. As an alternative to pursuing such "crisis management" in our patients, Bon Secours St. Francis Cancer Center (BSSF) initiated Interdisciplinary Care (IDC) Rounds in an effort to anticipate patient needs, enhance quality of life (QoL), and potentially limit avoidable emergency room and hospital admissions...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27935778/anesthesia-involvement-in-palliative-care
#8
Amanda C Faircloth
Palliative care teams require multidisciplinary support. While this is an emerging area in anesthesia practice, there are many avenues for certified registered nurse anesthetists (CRNAs) to share their unrivaled clinical knowledge. CRNAs may become involved with or consult on palliative sedation, medical management, interventional pain management, terminal wean/extubation, and organ donation. Additionally, CRNAs need to understand the unique needs of this patient population so that they can appropriately care for palliative care patients presenting to the operating room for palliative surgery...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27894008/common-or-multiple-futures-for-end-of-life-care-around-the-world-ideas-from-the-waiting-room-of-history
#9
REVIEW
Shahaduz Zaman, Hamilton Inbadas, Alexander Whitelaw, David Clark
Around the world there is growing interest in the manner in which care is delivered to people at the end of life. However, there is little unanimity on what constitutes a 'good death' and the appropriate societal responses to the issue of delivering culturally relevant and sustainable forms of end of life care in different settings are not subjects of broad agreement. In this critical conceptual paper we focus on the emerging narratives of global palliative care and offer an assessment of their implications...
January 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/27688616/early-integration-of-palliative-medicine-into-emergency-care-is-it-a-feasible-option
#10
Shrikant Atreya
Patients with advanced malignancy often experience symptoms of disease and treatment that contribute to distress and diminish their quality of life. Most of these patients present to the emergency department thus raising its importance in providing such care especially at the end of life situation. An approach that is aimed at controlling these symptoms, whether or not undergoing curative therapy, is a key feature of high-quality patient-centered care. This paper explores the potential role of palliative medicine in the emergency room and how early integration with emergency care can help improve the quality of life of patients and thus achieve better outcomes...
July 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/27650201/end-of-life-care-for-hispanic-children-a-study-of-california-medicaid-beneficiaries
#11
Lisa C Lindley, Laura V Trujillo
INTRODUCTION: More than 8,000 Hispanic children die annually in the United States; yet little is known about the end-of-life care utilized. The purpose of this study was to examine the children and family characteristics associated with end-of-life care for Hispanic children. METHOD: A sample of 370 Hispanic children was created, using the 2009-2010 California Medicaid data. The relationship between child and family characteristics and end-of-life care utilization (i...
December 2016: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/27610349/single-institution-experience-with-the-ladd-s-procedure-in-patients-with-heterotaxy-and-stage-i-palliated-single-ventricle
#12
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/27570357/does-the-culture-of-modern-day-palliative-care-social-work-leave-room-for-leadership
#13
Jason Davidson
This paper describes research undertaken as part of an MA study in leadership. It draws on interviews with six high profile leaders at the fore front of end of life care sector in the UK. Its findings and emerging themes offer insights about the opportunities for social work leaders in palliative care in the future and how the profession and palliative care sector address current barriers to taking advantage of such opportunity. The main focus of this paper is leadership related to palliative care social work...
April 2, 2016: Journal of Social Work Practice
https://www.readbyqxmd.com/read/27559252/integration-of-early-specialist-palliative-care-in-cancer-care-and-patient-related-outcomes-a-critical-review-of-evidence
#14
Naveen Salins, Raghavendra Ramanjulu, Lipika Patra, Jayita Deodhar, Mary Ann Muckaden
INTRODUCTION: World Health Organization and American Society of Clinical Oncology recommend early integration of specialist palliative care in patients with cancer. This paper focuses on critical review of evidence on integration of early specialist palliative care in cancer care and patient-related outcomes. METHODS: The question for the literature search was - Does integration of early specialist palliative care in cancer care influences patient-related outcomes? 31 articles related to literature search review question were included in this paper...
July 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27140033/perceptions-of-palliative-care-in-the-nicu
#15
Alison J Falck, Sheela Moorthy, Brenda Hussey-Gardner
BACKGROUND AND PURPOSE: The American Academy of Pediatrics supports palliative care (PC) for all children with life-threatening illnesses. Thus, many neonatal intensive care unit (NICU) patients and their families could benefit from PC. Our study objective was to examine provision of PC as experienced by mothers and healthcare providers (HCPs) of NICU patients with life-threatening illnesses. Palliative care components explored included communication, choices, comfort, psychosocial and spiritual needs, and coordination of care...
June 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27097501/-taking-an-active-part-in-a-palliative-care-unit-as-an-anesthesiologist
#16
Toshihiko Nakatani
Palliative care prevents and relieves total pain of patients and their families and improves their quality of life. The author describes the work of anesthesiologists in palliative care unit as ward staffs. The need for palliative care units is increasing and new palliative care units are being established throughout Japan. Anesthesiologists are involved in anesthesia, pain management intensive care, emergency medicine and palliative care. The anesthesiologists in palliative care are involved in use of opioid and nerve block for treating physical pain...
March 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27091417/palliative-chemotherapy-affects-aggressiveness-of-end-of-life-care
#17
Chin-Chia Wu, Ta-Wen Hsu, Chun-Ming Chang, Cheng-Hung Lee, Chih-Yuan Huang, Ching-Chih Lee
INTRODUCTION: Although palliative chemotherapy during end-of-life care is used for relief of symptoms in patients with metastatic cancer, chemotherapy may lead to more aggressive end-of-life care and less use of hospice service. This is a population-based study of the association between palliative chemotherapy and aggressiveness of end-of-life care. PATIENTS AND METHODS: Using the National Health Insurance Research Database of Taiwan, we identified 49,920 patients with metastatic cancer who underwent palliative chemotherapy from January 1, 2009, to December 31, 2011...
June 2016: Oncologist
https://www.readbyqxmd.com/read/26769146/utilization-of-palliative-care-and-acute-care-services-in-older-adults-with-advanced-cancer
#18
Namita Sharma, Amit M Sharma, Martha A Wojtowycz, Dongliang Wang, Ajeet Gajra
OBJECTIVES: There is a gap in knowledge regarding the rates of utilization of palliative care services (PCS) and acute care services (ACS) among older patients with advanced cancer close to end of life. We analyzed the utilization of these services among older adults (65 years and older) and compared them to those in younger adults (40-64 years) with advanced cancer. MATERIALS AND METHODS: A retrospective chart review of 567 veterans who died with advanced cancer between 2002 and 2009 and utilized PCS and ACS prior to death was conducted after IRB approval...
January 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/26748741/lived-experience-of-caring-for-dying-patients-in-emergency-room
#19
Waraporn Kongsuwan, Yaowarat Matchim, Kittikorn Nilmanat, Rozzano C Locsin, Tetsuya Tanioka, Yuko Yasuhara
BACKGROUND: Dying often occurs in hospitals and frequently in emergency rooms. Understanding caring for critical and dying patients is necessary for quality nursing. PURPOSE: This study described the meaning of nurses' lived experience of caring for critical and dying patients in the emergency rooms. METHODS: This study was conducted in three emergency rooms of tertiary hospitals in southern Thailand. Twelve nurses met the inclusion criteria: nurses working in emergency room for at least 2 years, and experienced caring for critical and dying patients in an emergency department...
March 2016: International Nursing Review
https://www.readbyqxmd.com/read/26687283/a-pilot-tuning-project-based-national-study-on-recently-graduated-medical-students-self-assessment-of-competences-the-test-study
#20
Pedro Grilo Diogo, Joselina Barbosa, Maria Amélia Ferreira
BACKGROUND: The Tuning Project is an initiative funded by the European Commission that developed core competences for primary medical degrees in Europe. Students' grouped self-assessments are used for program evaluation and improvement of curricula. The TEST study aimed to assess how do Portuguese medical graduates self-assess their acquisition of core competences and experiences of contact with patients in core settings according to the Tuning framework. METHODS: Translation of the Tuning's competences (Clinical Practice - CP), Knowledge (K) items and Clinical Settings (CS) was performed...
2015: BMC Medical Education
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