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Palliative care in stroke

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https://www.readbyqxmd.com/read/28169104/-benchmarking-in-patient-identification-an-opportunity-to-learn
#1
R M Salazar-de-la-Guerra, A Santotomás-Pajarrón, V González-Prieto, M D Menéndez-Fraga, C Rocha Hurtado
OBJECTIVE: To perform a benchmarking on the safe identification of hospital patients involved in "Club de las tres C" (Calidez, Calidad y Cuidados) in order to prepare a common procedure for this process. MATERIAL AND METHODS: A descriptive study was conducted on the patient identification process in palliative care and stroke units in 5medium-stay hospitals. The following steps were carried out: Data collection from each hospital; organisation and data analysis, and preparation of a common procedure for this process...
February 3, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28152436/an-individualized-coaching-program-for-patients-with-acute-ischemic-stroke-feasibility-study
#2
P Vanacker, D Standaert, N Libbrecht, I Vansteenkiste, D Bernard, L Yperzeele, G Vanhooren
OBJECTIVES: An individualized stroke care program was developed to match patients' education with their needs regarding stroke knowledge, secondary prevention and rehabilitation. Our purpose was to assess feasibility of in-hospital and post-discharge, personalized stroke coaching service. METHODS: Acute ischemic stroke patients enrolled in ASTRAL-B stroke registry (Sint-Lucashospital, Bruges Belgium) with: (a) hospitalization between 12/2014-12/2015, (b) hospital-to-home discharge, and (c) without cognitive decline, were selected...
March 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28135810/post-acute-care-facility-as-a-discharge-destination-for-patients-in-need-of-palliative-care-in-brazil
#3
Luiz Guilherme L Soares, André M Japiassu, Lucia C Gomes, Rogéria Pereira
Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28056515/race-ethnicity-as-a-predictor-for-location-of-death-in-patients-with-acute-neurovascular-events
#4
Say Salomon, Elizabeth Chuang, Deepa Bhupali, Daniel Labovitz
BACKGROUND: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. METHODS: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27898260/inpatient-palliative-care-for-neurological-disorders-lessons-from-a-large-retrospective-series
#5
Ying Liu, Danielle Kline, Shanae Aerts, Jeanie M Youngwerth, Jean S Kutner, Stefan Sillau, Benzi M Kluger
BACKGROUND: Patients with neurological disorders are the second most common patient population to receive inpatient palliative care services after cancer; however, there have been few reports describing the characteristics and needs of this population. OBJECTIVE: To understand which patients with neurological diagnoses utilized these services, reasons for consultation, and whether patterns of use changed over time. DESIGN: Retrospective case series...
January 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27827327/nursing-s-role-in-addressing-palliative-care-needs-of-stroke-patients
#6
Barbara J Lutz, Theresa Green
No abstract text is available yet for this article.
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27763820/is-there-hope-is-she-there-how-families-and-clinicians-experience-severe-acute-brain-injury
#7
Rachael E C Schutz, Heather L Coats, Ruth A Engelberg, J Randall Curtis, Claire J Creutzfeldt
BACKGROUND: Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE: The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of patients with SABI receiving care in the neuroscience intensive care unit (neuro-ICU). DESIGN: Semistructured interviews were audiotaped, transcribed, and analyzed using thematic analysis...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27758809/dying-with-a-left-ventricular-assist-device-as-destination-therapy
#8
Shannon M Dunlay, Jacob J Strand, Sara E Wordingham, John M Stulak, Angela J Luckhardt, Keith M Swetz
BACKGROUND: Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS: All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record...
October 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27676908/mobile-team-rehabilitation-rehabilitation-an-activity-outside-results-of-3-years-of-functioning-to-the-p%C3%A3-le-saint-helier
#9
Aurélie Duruflé, Claire Le-Meur, Marie-Pierre Reillon, Claire Lozach, Benoit Nicolas
Many mobile teams were created over the past decade in various medical specialties including physical medicine and rehabilitation (MPR). The Pôle Saint-Helier has created a mobile team of rehabilitation-reintegration (EM2R) in December 2012 with support from the Regional Health Agency of Brittany. It operates on the health territory No. 5 of Brittany near people experiencing neurological disability. Its main mission is to implement the necessary devices to facilitate the home return of people hospitalized after a neurological event or maintaining to home people with neurological disorders...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27503067/palliative-care-and-cardiovascular-disease-and-stroke-a-policy-statement-from-the-american-heart-association-american-stroke-association
#10
Lynne T Braun, Kathleen L Grady, Jean S Kutner, Eric Adler, Nancy Berlinger, Renee Boss, Javed Butler, Susan Enguidanos, Sarah Friebert, Timothy J Gardner, Phil Higgins, Robert Holloway, Madeleine Konig, Diane Meier, Mary Beth Morrissey, Tammie E Quest, Debra L Wiegand, Barbara Coombs-Lee, George Fitchett, Charu Gupta, William H Roach
The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions...
September 13, 2016: Circulation
https://www.readbyqxmd.com/read/27474339/usefulness-of-palliative-care-to-complement-the-management-of-patients-on-left-ventricular-assist-devices
#11
Nancy Luo, Joseph G Rogers, Gwen C Dodson, Chetan B Patel, Anthony N Galanos, Carmelo A Milano, Christopher M O'Connor, Robert J Mentz
Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of complications including infections, bleeding episodes, and stroke. The candidate for left ventricular assist device therapy faces complex challenges going forward, both physical and psychological, many of which may benefit from the application of palliative care principles by trained specialists...
September 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27380854/self-reported-impact-of-caregiving-on-voluntary-home-based-caregivers-in-mutale-municipality-south-africa
#12
Ntsieni S Mashau, Vhonani O Netshandama, Makondelela J Mudau
BACKGROUND: The establishment of home-based care (HBC) programmes in developing countries has resulted in a shift of burden from hospitals to communities where palliative care is provided by voluntary home-based caregivers. AIM: The study investigated the impact of caregiving on voluntary home-based caregivers. SETTING: The study was conducted at HBC organisations located in Mutale Municipality of Limpopo Province, South Africa. METHODS: A quantitative cross-sectional descriptive survey design was applied to investigate the impact of caregiving on voluntary home-based caregivers...
May 31, 2016: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/27315656/nursing-older-people-best-practice-forum
#13
(no author information available yet)
Forty-two study days designed for nurses involved in the care of older people are being organised across Britain, entitled Nursing Older People: Best Practice Forum. The RCNaccredited full-day seminars include presentations from four eminent speakers on areas of current interest, including palliative care in the community, medicine administration issues, healthcare law and care following a stroke.
June 1, 2003: Nursing Older People
https://www.readbyqxmd.com/read/27264617/-anticholinergic-burden-and-delirium-in-elderly-patients-during-acute-hospital-admission
#14
Aurora M Rojo-Sanchís, Manuel Vélez-Díaz-Pallarés, María Muñoz García, Eva Delgado Silveira, Teresa Bermejo Vicedo, Alfonso Cruz Jentoft
BACKGROUND: The use of anticholinergic drugs in the elderly has been associated to an increased frequency of delirium. There are different scales for estimating the anticholinergic burden, such as the Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and Anticholinergic Cognitive Burden (ACB). The aim of the study is to establish the relationship between anticholinergic burden measured by ADS, ARS, and ACB scales and incident or prevalent delirium. METHODS: An ambispective observational study was conducted for 76 days in the acute geriatric unit of a tertiary hospital...
July 2016: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/27075141/predicting-performance-status-1-year-after-critical-illness-in-patients-80-years-or-older-development-of-a-multivariable-clinical-prediction-model
#15
Daren K Heyland, Henry T Stelfox, Allan Garland, Deborah Cook, Peter Dodek, Jim Kutsogiannis, Xuran Jiang, Alexis F Turgeon, Andrew G Day
OBJECTIVE: We sought to develop and internally validate a clinical prediction model to estimate the outcome of very elderly patients 12 months after being admitted to the ICU. DESIGN: Prospective, longitudinal cohort study. SETTING: Twenty-two Canadian ICUs. PATIENTS: We recruited 527 patients 80 years or older who had a medical or urgent surgical diagnosis and were admitted to an ICU for at least 24 hours. MEASUREMENTS AND MAIN RESULTS: At baseline, we completed a comprehensive geriatric assessment of enrolled patients; survival and functional status was determined 12 months later...
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27067880/cardiac-arrest-in-acute-ischemic-stroke-incidence-predisposing-factors-and-clinical-outcomes
#16
Raed A Joundi, Alejandro A Rabinstein, Davar Nikneshan, Jack V Tu, Jiming Fang, Robert Holloway, Gustavo Saposnik
BACKGROUND: Cardiac arrest is a devastating complication of acute ischemic stroke, but little is known about its incidence and characteristics. We studied a large ischemic stroke inpatient population and compared patients with and without cardiac arrest. METHODS: We studied consecutive patients from the Ontario Stroke Registry who had an ischemic stroke between July 2003 and June 2008 at 11 tertiary care stroke centers in Ontario. Multivariable analyses were used to determine independent predictors of cardiac arrest and associated outcomes...
July 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27044257/end-of-life-decisions-in-acute-stroke-patients-an-observational-cohort-study
#17
Angelika Alonso, Anne D Ebert, Dorothee Dörr, Dieter Buchheidt, Michael G Hennerici, Kristina Szabo
BACKGROUND: Crucial issues of modern stroke care include best practice end-of-life-decision (EOLD)-making procedures and the provision of high-quality palliative care for dying stroke patients. METHODS: We retrospectively analyzed records of those patients who died over a 4-year period (2011-2014) on our Stroke Unit concerning EOLD, focusing on the factors that most probably guided decisions to induce limitation of life-sustaining therapy and subsequently end-of-life-care procedures thereafter...
2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27016841/posterior-circulation-ischemia-or-occlusion-in-five-adults-with-failing-fontan-circulation
#18
Eileen Broomall, Mary E McBride, Barbara J Deal, Laurence Ducharme-Crevier, Alexandra Shaw, Mjaye Mazwi, Carl L Backer, Michael C Mongé, John Costello, Bradley S Marino, Andrew DeFreitas, Mark S Wainwright
BACKGROUND: Palliative procedures performed before the Fontan procedure may require ligation of the subclavian arteries, thereby affecting flow to the vertebral arteries. In adults with functionally univentricular heart disease, the implications of altered brainstem vascular anatomy for perioperative management of failing Fontan circulation are not known. METHODS: We identified abnormal posterior circulation anatomy in an adult patient with failing Fontan circulation who experienced a brainstem stroke after Fontan conversion...
June 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26886009/predictors-of-extubation-success-in-patients-with-posterior-fossa-strokes
#19
Pramod K Guru, Tarun D Singh, Swetha Pedavally, Alejandro A Rabinstein, Sara Hocker
OBJECTIVE: Posterior fossa stroke is unique in its presentation and outcomes, and mechanical ventilation is commonly used in the management of these patients. We aimed to identify predictors of extubation success in patients with posterior fossa stroke, who require mechanical ventilation. DESIGN: We included consecutive adult patients admitted to the neurosciences ICU from January 2003 to December 2012. Extubation failure was defined as re-intubation within 7 days of extubation...
August 2016: Neurocritical Care
https://www.readbyqxmd.com/read/26857358/predictors-of-place-of-death-in-south-west-scotland-2000-2010-retrospective-cohort-study
#20
Heather Black, Craig Waugh, Rosalia Munoz-Arroyo, Andrew Carnon, Ananda Allan, David Clark, Fiona Graham, Christopher Isles
BACKGROUND: Surveys suggest most people would prefer to die in their own home. AIM: To examine predictors of place of death over an 11-year period between 2000 and 2010 in Dumfries and Galloway, south west Scotland. DESIGN: Retrospective cohort study. SETTING/PARTICIPANTS: 19,697 Dumfries and Galloway residents who died in the region or elsewhere in Scotland. We explored the relation between age, gender, cause of death (cancer, respiratory, ischaemic heart disease, stroke and dementia) and place of death (acute hospital, cottage hospital, residential care and home) using regression models to show differences and trends...
September 2016: Palliative Medicine
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