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Palliative care emergency department

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https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#1
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27903774/-they-shouldn-t-be-coming-to-the-ed-should-they-a-descriptive-service-evaluation-of-why-patients-with-palliative-care-needs-present-to-the-emergency-department
#2
Emilie Green, Sarah Ward, Will Brierley, Ben Riley, Henna Sattar, Tim Harris
BACKGROUND: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. METHODS: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period...
November 30, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27858564/preparing-for-value-based-payment-a-stepwise-approach-for-cancer-centers
#3
Kerin B Adelson, Salimah Velji, Kavita Patel, Basit Chaudhry, Catherine Lyons, Rogerio Lilenbaum
Most cancer centers are ill-equipped to pursue value-based payment (VBP) because of limited information on their population's cost of care. Herein, we outline the stepwise approach used by Smilow Cancer Hospital at Yale-New Haven in our pursuit of better value care. First, we addressed institutional barriers. A move toward value required demonstration to Yale-New Haven Health System leadership that OCM would improve patient care, fund new infrastructure, and provide the opportunity to gain experience with VBP without a major threat to the financial stability of the health system...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27846111/experiences-of-healthcare-professionals-in-providing-palliative-end-of-life-care-to-patients-in-emergency-departments-a-systematic-review-protocol
#4
Kai Yeung Cheung, Kai Chiu Chan
The objective of this review is to identify and synthesize the best available evidence on the experiences of healthcare professionals in providing palliative care to patients at the end of life in emergency departments.
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27807085/-i-ll-be-in-a-safe-place-a-qualitative-study-of-the-decisions-taken-by-people-with-advanced-cancer-to-seek-emergency-department-care
#5
Lesley A Henson, Irene J Higginson, Barbara A Daveson, Clare Ellis-Smith, Jonathan Koffman, Myfanwy Morgan, Wei Gao
OBJECTIVE: To explore the decisions of people with advanced cancer and their caregivers to seek emergency department (ED) care, and understand the issues that influence the decision-making process. DESIGN: Cross-sectional qualitative study incorporating semistructured patient and caregiver interviews. METHODS: Between December 2014 and July 2015, semistructured interviews were conducted with 18 people with advanced cancer, all of whom had recently attended the ED of a large university teaching hospital located in south-east London; and six of their caregivers...
November 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27777376/issues-using-linkage-of-hospital-records-and-death-certificate-data-to-determine-the-size-of-a-potential-palliative-care-population
#6
Kate Brameld, Katrina Spilsbury, Lorna Rosenwax, Kevin Murray, James Semmens
BACKGROUND: Studies aiming to identify palliative care populations have used data from death certificates and in some cases hospital records. The size and characteristics of the identified populations can show considerable variation depending on the data sources used. It is important that service planners and researchers are aware of this. AIM: To illustrate the differences in the size and characteristics of a potential palliative care population depending on the differential use of linked hospital records and death certificate data...
October 24, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27769258/reasons-for-transferral-to-emergency-departments-of-terminally-ill-patients-a-french-descriptive-and-retrospective-study
#7
Pierre Cornillon, Sébastien Loiseau, Bruno Aublet-Cuvelier, Virginie Guastella
BACKGROUND: Patients under palliative care and in hospital-at-home services are frequently transferred to emergency departments. We set out to identify the reasons for these presentations to determine the proportion that might be avoidable. METHODS: We conducted a retrospective study by assessment of patient files. We studied admissions to four emergency departments in an area of France (Puy-de-Dôme) between September 2011 and August 2013. Reasons for transfer and diagnostic conclusion by emergency doctors were noted...
October 21, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27722910/niv-by-an-interdisciplinary-respiratory-care-team-in-severe-respiratory-failure-in-the-emergency-department-limited-to-day-time-hours
#8
Christian Michael Horvath, Martin Horvath Brutsche, Otto Dagobert Schoch, Bernarde Schillig, Florent Baty, Dieter vonOw, Jochen Julius Rüdiger
Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) would be feasible and could improve patient´s dyspnoea measured by respiratory rate and Borg visual dyspnea scale. NIV was set up by an interdisciplinary respiratory care team. Outside these predefined hours NIV was performed in the ICU...
October 8, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27701845/end-of-life-issues-withdrawal-and-withholding-of-life-sustaining-healthcare-in-the-emergency-department-a-comparison-between-emergency-physicians-and-emergency-registrars-a-sub-study
#9
Philip G Richardson, Jaimi Greenslade, Jonathon Isoardi, Michael Davey, Mark Gillett, Alicia Tucker, Sharon Klim, Anne-Maree Kelly, Ibrahim Abdelmahmoud
OBJECTIVE: We investigated and compared the importance of the considerations and discussions when withdrawing and withholding life-sustaining healthcare between emergency physicians (EP) and emergency registrars (ER). METHODS: This was a sub-study of a prospective cross-sectional questionnaire-based case series conducted in six EDs. Primary outcomes were, which of the discussion and considerations, were rated most important by EP and ER in the decision-making process...
October 4, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27698520/re-staging-following-long-course-chemoradiotherapy-for-rectal-cancer-does-it-influence-management
#10
A McBrearty, K McCallion, R J Moorehead, I McAllister, K Mulholland, R Gilliland, W J Campbell
BACKGROUND: In patients with locally advanced or low rectal cancers, long-course chemoradiotherapy (LCCRT) is recommended prior to surgical management.(1) The need for restaging afterwards has been questioned as it may be difficult to interpret imaging due to local tissue effects of chemoradiotherapy. The purpose of this study was to determine if restaging affected the management of patients receiving long-course chemoradiotherapy for rectal cancer. METHODS: A retrospective review of patients with rectal cancer discussed at the South Eastern Health and Social Care Trust Lower Gastrointestinal Multi-Disciplinary Team Meeting (LGIMDT) in 2013 who had received long-course chemoradiotherapy was performed...
September 2016: Ulster Medical Journal
https://www.readbyqxmd.com/read/27688616/early-integration-of-palliative-medicine-into-emergency-care-is-it-a-feasible-option
#11
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/27673357/sedation-by-propofol-for-painful-care-procedures-at-the-end-of-life-a-pilot-study-propopal-1
#12
Jean François Ciais, Flora Tremellat, Maud Castelli-Prieto, Caroline Jestin
BACKGROUND: At the end of life, patients may feel refractory pain during care procedures although they receive appropriate analgesia. They can benefit from a short-term sedation. Propofol is used for procedural sedation in emergency or reanimation departments. It may be adapted in a palliative care unit. OBJECTIVE: The main objective was to verify whether propofol could allow us to administer care without causing major pain to patients with refractory pain at the end of life...
September 27, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27663192/case-conference-primary-secondary-care-planning-at-end-of-life-can-reduce-the-cost-of-hospitalisations
#13
Samantha Hollingworth, Jianzhen Zhang, Bharat Phani Vaikuntam, Claire Jackson, Geoffrey Mitchell
BACKGROUND: To plan integrated care at end of life for people with either heart failure or lung disease, we used a case conference between the patient's general practitioner (GP), specialist services and a palliative care consultant physician. This intervention significantly reduced hospitalisations and emergency department visits. This paper reports estimates of potential savings of reduced hospitalisation through end of life case conferences in a pilot study. METHODS: We used Australian Refined Diagnosis Related Group codes to obtain data on hospitalisations and costs...
September 23, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27658500/prevalence-of-systemic-anti-cancer-therapy-for-patients-within-the-last-30-days-of-life-experience-in-a-private-hospital-oncology-group
#14
Lironne Wein, Catherine Rowe, Benjamin Brady, Despina Handolias, Lara Lipton, David Pook, Robert Stanley, Ian Haines
BACKGROUND: In recent years there has been a significant increase in the number of cancer treatments that have become available. However, it has remained difficult to choose the most appropriate time to cease active therapy in individual patients. AIM: To determine the proportion of patients being treated with palliative intent who received systemic anticancer treatment in the last 30 days of life. METHODS: This is a retrospective cohort study conducted within the Melbourne Oncology Group at Cabrini Hospital...
September 23, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27651210/policy-on-end-of-life-and-palliative-care-in-the-emergency-department-p455
#15
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27641157/palliative-care-consultations-in-nursing-homes-and-reductions-in-acute-care-use-and-potentially-burdensome-end-of-life-transitions
#16
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson
OBJECTIVES: To evaluate how receipt and timing of nursing home (NH) palliative care consultations (primarily by nurse practitioners with palliative care expertise) are associated with end-of-life care transitions and acute care use DESIGN: Propensity score-matched retrospective cohort study. SETTING: Forty-six NHs in two states. PARTICIPANTS: Nursing home residents who died from 2006 to 2010 stratified according to days between initial consultation and death (≤7, 8-30, 31-60, 61-180)...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27632230/feasibility-testing-of-an-emergency-department-screening-tool-to-identify-older-adults-appropriate-for-palliative-care-consultation
#17
Kei Ouchi, Susan D Block, Mara A Schonberg, Emily S Jamieson, Emily L Aaronson, Daniel J Pallin, James A Tulsky, Jeremiah D Schuur
BACKGROUND: Seriously ill older adults in the emergency department (ED) may benefit from palliative care referral, yet little is known about how to identify these patients. OBJECTIVES: To assess the performance and determine the acceptability of a content-validated palliative care screening tool. DESIGN: We surveyed Emergency Medicine (EM) attending physicians at the end of their shifts using the screening tool and asked them to retrospectively apply it to all patients ≥65 years whom they had cared for...
September 15, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27625887/olfactory-neuroblastoma-followed-by-emergency-surgery-for-symptomatic-intradural-spinal-metastasis-a-case-report
#18
Masatoshi Yunoki, Kenta Suzuki, Atsuhito Uneda, Kimihiro Yoshino
BACKGROUND: Olfactory neuroblastoma (ONB) is a rare, aggressive tumor of the nasal cavity. It may invade the paranasal cavities and anterior skull base locally but may also metastasize to the cervical lymph nodes, lungs, or distant central nervous system. CASE DESCRIPTION: Here, we report a case of ONB in which emergency surgery was performed for intradural spinal metastasis (ISM). The patient was a 52-year-old male who underwent surgery for ONB. The tumor extended from the nasal cavity to the intracranial space and was resected completely...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27623357/the-palliative-performance-scale-predicts-three-and-six-month-survival-in-older-adult-patients-admitted-to-the-hospital-through-the-emergency-department
#19
Matthew Babcock, Joanne Gould Kuntz, Dan Kowalsky, Nicholas Calitri, Anne M Kenny
BACKGROUND: There is often little information on long-term prognosis available for Emergency Medicine physicians when decisions on admission, treatment, or consultations are being made for patients. There is a new focus to understand if palliative support should be offered in the emergency department (ED) and the Palliative Performance Scale (PPS), a screening tool used in other settings in palliative care, has been little used in the ED. OBJECTIVE: The goal of this study was to assess the prognostic value of the PPS in predicting three- and six-month survival in patients admitted through the ED...
September 13, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27621805/reduction-of-psycho-spiritual-distress-of-an-elderly-with-advanced-congestive-heart-failure-by-life-review-interview-in-a-palliative-care-day-center
#20
Kwok-Ying Chan, Vikki Wai-Kee Lau, Ka-Chi Cheung, Richard Shek-Kwan Chang, Man-Lui Chan
OBJECTIVES: Major depression is common in patients hospitalized with congestive heart failure and is independently associated with increased re-hospitalization and mortality. METHODS: Hereby, we report the treatment for an elderly congestive heart failure patient with frequent emergency department visits having major depression and hopelessness. RESULTS: Treatment outcomes measured showed that depressed scores of psychosocial needs were reduced with life review interview therapy in a palliative care day center...
2016: SAGE open medical case reports
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