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https://www.readbyqxmd.com/read/28701842/quality-of-dying-in-the-medical-intensive-care-unit-comparison-between-thai-buddhists-and-thai-muslims
#1
Veerapong Vattanavanit, Supattra Uppanisakorn, Rungsun Bhurayanontachai, Bodin Khwannimit
BACKGROUND AND AIMS: Religious belief is an important aspect that influences the life of a patient, especially in Asia. We aim to compare the quality of death in an Intensive Care Unit (ICU) between Buddhists and Muslims from the perspectives of the relatives of the patients and the nurses and physicians. SUBJECTS AND METHODS: This was a cohort study of critically ill patients who died after admission to a medical ICU in Songklanagarind Hospital in Thailand between 2015 and 2016...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28699936/clinician-attitudes-regarding-icd-deactivation-in-dnr-dni-patients
#2
Andrew Bradley, Adam Marks
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) offer lifesaving therapies but can become burdensome at the end of life. Many ICD patients choose to implement a do-not-resuscitate/do-not-intubate (DNR/DNI) order. When hospitalized, patients are seen by a range of clinicians whose beliefs about ICD management in DNR/DNI patients may vary. OBJECTIVE: To assess clinician opinions on managing ICDs in DNR/DNI patients and stratify it by specialty and training level...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28676293/attitudes-toward-advance-directives-among-patients-and-their-family-members-in-china
#3
Lin Kang, Xiao-Hong Liu, Jing Zhang, Pei-Yan Shan, Jie-Ping Wang, Ping Zhong, Xiao-Hong Du, Yu-Feng Du, Bao-Cheng Yu, Nan Wei, Hui-Ling Lou, Ou Bian, Huai-Hong Chen, Fan Lin, Hong-Lian Zhou, Wen He, Huai-Cong Long, Lu-Rong Hong, Hui Su, Jun-Nan Yang, Yong-Liang Jiang, Ye Shi, Jing Ning, Fang Liang, Zhong Wang, Ting Gong, Ming-Lei Zhu, Xiao-Hong Ning, Zhi-Jun Chen, Liang-Kung Chen
OBJECTIVES: Chinese people are generally unfamiliar with the concept of advance care planning or advance directives (ACP/ADs), which raises dilemmas in life-support choice and can even affect clinical decision making. To understand and address the issues involved better, we investigated the awareness of ACP/ADs in China, as well as people's attitudes toward medical autonomy and end-of-life care. DESIGN: A multicenter cross-sectional survey, conducted from August 1 to December 31, 2016...
July 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28662781/do-not-resuscitate-orders-in-the-perioperative-environment-a%C3%A2-multidisciplinary-quality-improvement-project
#4
Malgorzata Baumann, Shelley Killebrew, Katherine Zimnicki, Katherine Balint
Do-not-resuscitate (DNR) orders in the perioperative environment must be managed according to national and institutional guidelines. Health care professionals, including perioperative nurses, may be unfamiliar with the guidelines and unsure of their role in reevaluating a DNR order. We conducted a multidisciplinary quality improvement project at a metropolitan community hospital that aimed to improve health care providers' compliance with the institutional policy, nursing involvement in DNR reevaluation, and communication between providers...
July 2017: AORN Journal
https://www.readbyqxmd.com/read/28659419/aggressiveness-of-care-following-intracerebral-hemorrhage-in-women-and-men
#5
Rahul Guha, Amelia Boehme, Stacie L Demel, Janet J Li, Xuemei Cai, Michael L James, Sebastian Koch, Carl D Langefeld, Charles J Moomaw, Jennifer Osborne, Padmini Sekar, Kevin N Sheth, E Woodrich, Bradford B Worrall, Daniel Woo, Seemant Chaturvedi
OBJECTIVE: To compare comorbidities and use of surgery and palliative care between men and women with intracerebral hemorrhage (ICH). METHODS: The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study is a prospective, multicenter, case-control study of ICH risk factors and outcomes. We compared comorbidities, treatments, and use of do-not-resuscitate (DNR) orders in men vs women. Multivariate analysis was used to assess the likelihood of ICH surgery and palliative care after adjustment for variables that were p < 0...
June 28, 2017: Neurology
https://www.readbyqxmd.com/read/28659217/ambiguities-and-violations-of-patient-autonomy-from-ontario-s-prehospital-do-not-resuscitate-form
#6
Christopher R Foerster
No abstract text is available yet for this article.
June 29, 2017: CJEM
https://www.readbyqxmd.com/read/28658025/determinants-of-receiving-palliative-care-and-ventilator-withdrawal-among-patients-with-prolonged-mechanical-ventilation
#7
Yang-Ching Chen, Hsien-Yu Fan, J Randall Curtis, Oscar Kuang-Sheng Lee, Chih-Kuang Liu, Sheng-Jean Huang
OBJECTIVES: Increasing numbers of patients with prolonged mechanical ventilation generates a tremendous strain on healthcare systems. Patients with prolonged mechanical ventilation suffer from long-term poor quality of life. However, no study has ever explored the willingness to receive palliative care or terminal withdrawal and the factors influencing willingness. DESIGN: Cross-sectional study. SETTING: Five different hospitals of Taipei City Hospital system...
June 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28638855/end-of-life-care-and-do-not-resuscitate-orders-how-much-does-age-influence-decision-making-a-systematic-review-and-meta-analysis
#8
REVIEW
Ifor Cook, Aimee L Kirkup, Lauren J Langham, Muminah A Malik, Gabriella Marlow, Ian Sammy
With population aging, "do not resuscitate" (DNAR) decisions, pertaining to the appropriateness of attempting resuscitation following a cardiac arrest, are becoming commoner. It is unclear from the literature whether using age to make these decisions represents "ageism." We undertook a systematic review of the literature using CINAHL, Medline, and the Cochrane database to investigate the relationship between age and DNAR. All 10 studies fulfilling our inclusion criteria found that "do not attempt resuscitation" orders were more prevalent in older patients; eight demonstrated that this was independent of other mediating factors such as illness severity and likely outcome...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28625532/emergency-department-do-not-resuscitate-order-in-patients-with-spontaneous-intracerebral-hemorrhage
#9
Ju-Sing Fan, Hsien-Hao Huang, Yen-Chia Chen, Chorng-Kuang How, David Hung-Tsang Yen
OBJECTIVES: To explore the determinant factors and prognostic significance of emergency department do-not-resuscitate (ED-DNR) orders for patients with spontaneous intracerebral hemorrhage (SICH). METHODS: Consecutive adult SICH patients treated in our ED from January 1, 2012 to December 31, 2016 were selected as the eligible cases from our hospital's stroke database. Patients' information was comprehensively reviewed from the database and medical and nursing charts...
June 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#10
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28620153/premature-labor-and-neonatal-septicemia-caused-by-capnocytophaga-ochracea
#11
Abdullah A Alhifany, Thamer A Almangour, Deanne E Tabb, David H Levine
BACKGROUND Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. CASE REPORT A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby...
June 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28614079/do-not-resuscitate-with-no-surrogate-and-no-advance-directive-an-ethics-case-study
#12
Jamie Diamond, Umesh Gidwani, Rosamond Rhodes
Do-not-resuscitate (DNR) orders are typically signed by physicians in conjunction with patients or their surrogate decision makers in order to instruct healthcare providers not to perform cardiopulmonary resuscitation (CPR). Both the medical literature and CPR guidelines fail to address when it is appropriate for physicians to sign DNR orders without any knowledge of a patient's wishes. We explore the ethical issues surrounding instituting a two-physician DNR for a dying patient with multiple comorbidities and no medical record on file, no advance directives, and no surrogate decision maker...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28602096/access-to-palliative-care-for-patients-undergoing-mechanical-ventilation-with-idiopathic-pulmonary-fibrosis-in-the-united-states
#13
Barret Rush, Landon Berger, Leo Anthony Celi
OBJECTIVE: The utilization of palliative care (PC) in patients with end-stage idiopathic pulmonary fibrosis (IPF) is not well understood. METHODS: The Nationwide Inpatient Sample (NIS) was utilized to examine the use of PC in mechanically ventilated (MV) patients with IPF. The NIS captures 20% of all US inpatient hospitalizations and is weighted to estimate 95% of all inpatient care. RESULTS: A total of 55 208 382 hospital admissions from the 2006 to 2012 NIS samples were examined...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#14
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28594585/impact-of-palliative-medicine-involvement-on-end-of-life-services-for-patients-with-cancer-with-in-hospital-deaths
#15
Alison Wiesenthal, Debra A Goldman, Deborah Korenstein
PURPOSE: Palliative care (PC) has been shown to improve the quality of care and resource utilization for inpatients. We examined the relationship between PC consultation before and during final admission and patterns of care for dying patients at our tertiary cancer center. METHODS: We retrospectively reviewed adult patients with solid tumor cancer with a length of stay ≥ 3 days who died in hospital between December 2012 and November 2014. We recorded services, including laboratory testing, imaging, blood products, medications, diet orders, do not resuscitate orders, and consultations, delivered within 3 days of death...
June 8, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28557015/palestinian-community-perceptions-of-do-not-resuscitation-order-for-terminally-ill-patients-a-qualitative-study
#16
Intima Alrimawi, Ahmad Rajeh Saifan, Raghad Abdelkader, Abdul-Monim Batiha
AIM AND OBJECTIVES: This study aims to illustrate the Palestinian community's views, opinions and stances about the concept of do not resuscitate (DNR) for terminally ill patients. BACKGROUND: DNR orders are practiced in many countries worldwide, but there is no consensus on their practice in the Middle East. DNR orders may be applied for terminally ill pediatric patients. Some studies have been conducted describing people's experiences with these DNR orders. However, few studies have considered community perspectives on DNR orders for terminally ill patients in Palestine...
May 30, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28555783/implementation-of-a-critical-care-outreach-service-a-qualitative-study
#17
A Jeddian, A Lindenmeyer, T Marshall, A F Howard, L Sayadi, A Rashidian, N Jafari
AIM: The aim of this study was to explore hospital staff perceptions of the perceived challenges and outcomes of implementing a critical care outreach service. BACKGROUND: A nurse-led critical care outreach service was designed and implemented to identify and treat acutely ill patients in a large tertiary care hospital in Iran. METHODS: A qualitative analysis of data from two focus groups and seven interviews was carried out using conventional content analyses techniques...
May 29, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28540112/comparison-of-postoperative-outcomes-in-elderly-patients-with-a-do-not-resuscitate-order-undergoing-elective-and-nonelective-hip-surgery
#18
Anair Beverly, Ethan Y Brovman, Richard D Urman
PURPOSE: Emergency hip surgery generally has worse outcomes than elective hip surgery, even when adjusted for patient and surgical factors. Do-not-resuscitate (DNR) status patients are typically at higher perioperative risk and undergo a narrow range of surgical procedures. We aimed to compare the outcomes after hip surgery of differing degrees of urgency in this cohort. MATERIALS AND METHODS: Using National Surgical Quality Improvement Program (NSQIP) data, we conducted univariate and multivariate analyses comparing outcomes of DNR status patients after emergency and nonemergency hip surgery (2007-2013)...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28534181/assessing-decision-making-capacity-for-do-not-resuscitate-requests-in-depressed-patients-how-to-apply-the-communication-and-appreciation-criteria
#19
Benjamin D Brody, Ellen C Meltzer, Diana Feldman, Julie B Penzner, Janna S Gordon-Elliot
The Patient Self Determination Act (PSDA) of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient's preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity (DMC). In general, patients are presumed to have DMC. A patient's DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected...
May 22, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#20
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
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