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Hospice care

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https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#1
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#2
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28735271/a-collaborative-approach-to-facilitate-professionals-to-support-the-breathless-patient
#3
Vanessa Shaw, Alison Davies, Bie Nio Ong
OBJECTIVES: Breathlessness is a major problem for people in their last weeks of life. Breathlessness is considered to be multidimensional with physical, psychological, emotional, social and spiritual factors all playing a part. It has been recognised that specific training to health professionals is beneficial in order to improve the care for patients with breathlessness.Breathlessness courses have tended to focus on senior nurses. A new flexible and collaborative training course was designed to include a wider range of nurses and other health professionals in hospital, hospice, primary care and community settings...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#4
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28733043/perioperative-hypotension-and-discharge-outcomes-in-non-critically-injured-trauma-patients-a-single-centre-retrospective-cohort-study
#5
Nadav Sheffy, Itay Bentov, Brianna Mills, Bala G Nair, G Alec Rooke, Monica S Vavilala
BACKGROUND: There is a lack of information on the effect of age on perioperative care and outcomes after minor trauma in the elderly. We examined the association between perioperative hypotension and discharge outcome among non-critically injured adult patients. METHODS: We conducted a retrospective study of non-critically ill patients (ISS <9 or discharged within less than 24h) who received anaesthesia care for surgery and Recovery Room care at a level-1 trauma centre between 5/1/2012 and 11/30/2013...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28731821/trust-in-physicians-continuity-and-coordination-of-care-and-quality-of-death-in-patients-with-advanced-cancer
#6
Jun Hamano, Tatsuya Morita, Sakiko Fukui, Yoshiyuki Kizawa, Satoru Tunetou, Yasuo Shima, Makoto Kobayakawa, Maho Aoyama, Mitsunori Miyashita
BACKGROUND: Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. OBJECTIVE: To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home...
July 21, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28727486/association-of-physician-orders-for-life-sustaining-treatment-form-use-with-end-of-life-care-quality-metrics-in-patients-with-cancer
#7
Sandra L Pedraza, Stacey Culp, Mark Knestrick, Evan Falkenstine, Alvin H Moss
PURPOSE: Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs). METHODS: We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28723253/end-of-life-services-among-patients-with-cancer-evidence-from-cancer-registry-records-linked-with-commercial-health-insurance-claims
#8
Cara L McDermott, Catherine Fedorenko, Karma Kreizenbeck, Qin Sun, Bruce Smith, J Randall Curtis, Ted Conklin, Scott D Ramsey
PURPOSE: Despite guidelines emphasizing symptom management over aggressive treatment, end-of-life care for persons with cancer in the United States is highly variable. In consultation with a regional collaboration of patients, providers, and payers, we investigated indicators of high-quality end-of-life care to describe patterns of care, identify areas for improvement, and inform future interventions to enhance end-of-life care for patients with cancer. METHODS: We linked insurance claims to clinical information from the western Washington SEER database...
July 19, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28723252/across-the-continuum-how-inpatient-palliative-care-consultations-are-reported-in-hospital-discharge-summaries
#9
Nikki Miller, John Shuler, Deon Hayley, Jianghua He, Karin Porter-Williamson, Jessica Kalender-Rich
BACKGROUND: Inpatient Palliative Care (PC) consultations help develop a patient-centered and quality-of-life-focused plan of care for patients with serious illness. Discharge summaries (DSs) are an essential tool to maintain continuity of these care plans across multiple locations and providers. METHODS: We conducted a retrospective chart review of selected DSs of patients who received inpatient PC consultations at the University of Kansas Hospital from July 2011 to May 2015...
July 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28716613/a-novel-use-of-peer-coaching-to-teach-primary-palliative-care-skills-coaching-consultation
#10
Juliet Jacobsen, Corrine Alexander-Cole, Bethany-Rose Daubman, Dejani Banerji, Joe Greer, Karen o'Brien, Kathleen Doyle, Vicki Jackson
BACKGROUND: We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching. INTERVENTION: We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants). MEASUREMENTS: An audit of peer coaching encounters and coachee feedback to better understand the applicability of peer coaching in the inpatient setting to teach primary palliative care...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28710111/managing-an-intentional-overdose-in-a-hospice
#11
Toby Dinnen, Hannah Armstrong, Paul Perkins
This case report describes a patient admitted unconscious to a hospice following an intentional overdose of oxycodone. She had previously declined conventional medical treatment for cancer and had made an advance decision stating that she wished to avoid hospital admission and refusing life-prolonging treatment. This case illustrates the practical and ethical challenges of managing an intentional overdose in a palliative care setting.
July 14, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28708752/prevalence-of-burnout-in-health-professionals-working-in-palliative-care-a-systematic-review
#12
Vitor Parola, Adriana Coelho, Daniela Cardoso, Anna Sandgren, João Apóstolo
BACKGROUND: More than ever, the current increasing need for palliative care leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliative care put health professionals working in this context at the risk of burnout. OBJECTIVES: To examine the evidence on the prevalence of burnout among health professionals working in palliative care. INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review included studies that encompass qualified health professionals working in palliative care, caring for patients 18 years of age or older...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28708751/use-of-non-pharmacological-interventions-for-comforting-patients-in-palliative-care-a-scoping-review
#13
Adriana Coelho, Vítor Parola, Daniela Cardoso, Miguel Escobar Bravo, João Apóstolo
BACKGROUND: Palliative care aims to provide the maximum possible comfort to people with advanced and incurable diseases. The use of non-pharmacological interventions to promote comfort in palliative care settings has been increasing.However, information on implemented and evaluated interventions, their characteristics, contexts of application, and population is scattered in the literature, hampering the formulation of accurate questions on the effectiveness of those interventions and, consequently, the development of a systematic review...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28707460/the-effect-of-hospice-consultation-on-aggressive-treatment-of-lung-cancer
#14
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent five years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at SNUH who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed...
July 14, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#15
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28705849/anaplastic-carcinoma-of-thyroid-gland-with-widespread-soft-tissue-metastasis-an-unusual-presentation
#16
Muhammad Hassan, Taimoor Khalid Janjua, Hira Khan Afridi, Naila Anjum Zahid
Anaplastic thyroid cancer is the rarest tumour of the thyroid gland, representing only 2% of clinically recognised thyroid cancers. The most common metastatic sites are lungs, followed by the intrathoracic and neck lymph nodes. We report the case of a 62-year-old woman who presented to our setting with multiple soft tissue nodules, thyroid mass, head swelling and weight loss. Radiological investigation showed a large thyroid mass with widespread metastasis in subcutaneous tissues of both upper limbs, chest and abdomen...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28702499/metastasis-of-cervical-cancer-to-breast-a-case-report-and-review-of-literature
#17
Ankit Mangla, Nikki Agarwal, Farid Saei Hamedani, Jiaxiang Liu, Shweta Gupta, Michael R Mullane
Metastasis to the breast from an extra-mammary malignancy has been documented in literature, however cervical cancer metastasis to the breast is very rare. Thirty-eight cases of metastatic deposit to the breast from cervical cancer have been reported in literature. Though most patients present with a breast lump, it is very difficult to clinically distinguish a primary breast malignancy from a metastatic deposit. Histopathology of the tissue, aided with immune-histochemical staining pattern provides a definitive diagnosis...
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28693631/palliative-care-education-in-latin-america-a-systematic-review-of-training-programs-for-healthcare-professionals
#18
Cecilia Vindrola-Padros, Rosa Mertnoff, Cristina Lasmarias, Xavier Gómez-Batiste
OBJECTIVE: The integration of palliative care (PC) education into medical and nursing curricula has been identified as an international priority. PC education has undergone significant development in Latin America, but gaps in the integration of PC courses into undergraduate and postgraduate curricula remain. The aim of our review was to systematically examine the delivery of PC education in Latin America in order to explore the content and method of delivery of current PC programs, identify gaps in the availability of education opportunities, and document common barriers encountered in the course of their implementation...
July 11, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28692573/associations-of-hospice-disenrollment-and-hospitalization-with-continuous-home-care-provision
#19
Shi-Yi Wang, Weixiong Dang, Melissa D Aldridge, Maureen Canavan, Emily Cherlin, Elizabeth Bradley
OBJECTIVES: To examine rates of hospice disenrollment and posthospice hospitalization among patients who are enrolled in hospices that provide continuous home care (CHC) (CHC hospices) compared with patients who are enrolled in hospices that do not offer CHC (non-CHC hospices). METHODS: We performed a retrospective cohort study among Medicare fee-for-service decedents between July and December 2011, who were 66 years and older and had used hospice in their last 6 months of life...
July 7, 2017: Medical Care
https://www.readbyqxmd.com/read/28689992/characteristics-of-palliative-care-consultation-at-an-academic-level-one-trauma-center
#20
Emily B Rivet, Paula Ferrada, Tara Albrecht, J Brian Cassel, Beth Broering, Danielle Noreika, Egidio Del Fabbro
BACKGROUND: The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance. METHODS: A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period. RESULTS: The palliative care team evaluated 82 patients with a median age of 60 years...
June 28, 2017: American Journal of Surgery
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