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Advanced care planning recording

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https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#1
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27902412/the-staff-education-to-reducing-ventilator-associated-pneumonia
#2
Gurdal Yilmaz, Hava Aydin, Mustafa Aydin, Sedat Saylan, Hulya Ulusoy, Iftihar Koksal
Mechanical ventilation (MV) is a life-saving invasive procedure performed in intensive care units (ICUs) where critical patients are given advanced support. The purpose of this study was to assess the effect of personnel training on the incidence of ventilator-associated pneumonia (VAP). The study, performed prospectively in the ICU, was planned in two periods. In both periods, patient's characteristics were recorded on patient data forms. In the second period, ICU physicians and assistant health personnel were given regular theoretical and practical training...
October 17, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27893503/impacting-care-and-treatment-of-the-burn-patient-conversion-to-electronic-documentation
#3
Holly M Hampe, Terri Keeling, Michelle Fontana, Debbie Balcik
Improving patient care through enhanced electronic communication among health care providers is aimed at reducing the number of medication and medical errors. The American Reinvestment and Recovery Act (ARRA) was signed into law in 2009, supporting the federal government's commitment to the improvement of health care quality, safety, and efficiency through requirements to implement an electronic health record by October 2015 or hospitals and eligible providers potentially realizing penalties or reduced reimbursement rates...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27881091/conducting-a-large-multi-site-survey-about-patients-views-on-broad-consent-challenges-and-solutions
#4
Maureen E Smith, Saskia C Sanderson, Kyle B Brothers, Melanie F Myers, Jennifer McCormick, Sharon Aufox, Martha J Shrubsole, Nanibaá A Garrison, Nathaniel D Mercaldo, Jonathan S Schildcrout, Ellen Wright Clayton, Armand H Matheny Antommaria, Melissa Basford, Murray Brilliant, John J Connolly, Stephanie M Fullerton, Carol R Horowitz, Gail P Jarvik, Dave Kaufman, Terri Kitchner, Rongling Li, Evette J Ludman, Catherine McCarty, Valerie McManus, Sarah Stallings, Janet L Williams, Ingrid A Holm
BACKGROUND: As biobanks play an increasing role in the genomic research that will lead to precision medicine, input from diverse and large populations of patients in a variety of health care settings will be important in order to successfully carry out such studies. One important topic is participants' views towards consent and data sharing, especially since the 2011 Advanced Notice of Proposed Rulemaking (ANPRM), and subsequently the 2015 Notice of Proposed Rulemaking (NPRM) were issued by the Department of Health and Human Services (HHS) and Office of Science and Technology Policy (OSTP)...
November 24, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27876636/concordance-between-veterans-self-report-and-documentation-of-surrogate-decision-makers-implications-for-quality-measurement
#5
Kimberly K Garner, Patricia Dubbert, Shelly Lensing, Dennis H Sullivan
CONTEXT: The Measuring What Matters (MWM) initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. OBJECTIVES: To better understand the potential implementation of this MWM quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker...
November 19, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27875482/impact-of-community-health-workers-on-elderly-patients-advance-care-planning-and-health-care-utilization-moving-the-dial
#6
Debra K Litzelman, Thomas S Inui, Wilma J Griffin, Anthony Perkins, Ann H Cottingham, Kathleen M Schmitt-Wendholt, Steven S Ivy
BACKGROUND: Advance care planning (ACP) is recommended for all persons to ensure that the care they receive aligns with their values and preferences. OBJECTIVE: To evaluate an ACP intervention developed to better meet the needs and priorities of persons with chronic diseases, including mild cognitive impairment. RESEARCH DESIGN: A year-long, pre-post intervention using lay community health workers [care coordinator assistants (CCAs)] trained to conduct and document ACP conversations with patients during home health visits with pre-post evaluation...
November 21, 2016: Medical Care
https://www.readbyqxmd.com/read/27829425/evaluation-of-a-pilot-of-nurse-practitioner-led-gp-supported-rural-palliative-care-provision
#7
Geoffrey Keith Mitchell, Hugh Edgar Senior, Michael Peter Bibo, Blessing Makoni, Sharleen Nicole Young, John Patrick Rosenberg, Patsy Yates
BACKGROUND: Providing end of life care in rural areas is challenging. We evaluated in a pilot whether nurse practitioner (NP)-led care, including clinical care plans negotiated with involved health professionals including the general practitioner(GP), ± patient and/or carer, through a single multidisciplinary case conference (SMCC), could influence patient and health system outcomes. METHODS: Setting - Australian rural district 50 kilometers from the nearest specialist palliative care service...
November 9, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27767363/the-role-of-advanced-practice-registered-nurses-in-the-completion-of-physician-orders-for-life-sustaining-treatment
#8
Sophia A Hayes, Dana Zive, Betty Ferrell, Susan W Tolle
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm records advance care planning for patients with advanced illness or frailty as actionable medical records. The National POLST Paradigm Task Force recommends that physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) be permitted to execute POLST forms. OBJECTIVE: To investigate the percentage of Oregon POLST forms signed by APRNs, and examine the obstacles faced by states attempting to allow APRNs to sign POLST forms...
October 21, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27759188/resuscitation-orders-in-acute-hospitals-a-point-prevalence-study
#9
Amber Mills, Anne Walker, Michele Levinson, Alison M Hutchinson, Gemma Stephenson, Anthea Gellie, George Heriot, Harvey Newnham, Megan Robertson
OBJECTIVE: To determine the prevalence of resuscitation orders and Advance Care Plans, and the relationship with Medical Emergency Team (MET) calls. METHOD: A point prevalence review of patient records at five Victorian hospital services. RESULTS: One thousand nine hundred and thirty-four patient records were reviewed, and 230 resuscitation orders and 15 Advance Care Plans found. Significantly, more resuscitation orders were found at public hospitals...
October 19, 2016: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/27729481/end-of-life-care-patterns-at-a-community-hospital-the-rest-of-the-story
#10
Kip Waite, Jane Rhule, David Bush, Barry Meisenberg
We undertook a retrospective review of a subset of expired patients at our community hospital to evaluate end-of-life care patterns and the use of advanced care planning tools among patients who died in the hospital. These 162 expired patients fell into 1 of the 3 diagnosis-related groups of cardiac, respiratory, or infectious disease. Seventy-nine percent of patients arrived to the hospital with no requested limitations in the extent of resuscitative efforts, even though 98% of all patients had major or extreme severity of illness and risk of mortality scores...
October 11, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27729035/end-of-life-care-of-patients-with-idiopathic-pulmonary-fibrosis
#11
Kaisa Rajala, Juho T Lehto, M Saarinen, E Sutinen, T Saarto, M Myllärniemi
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive disease with median survival from 2 to 7 years. Palliative care is an important part of patients´ care as lung transplantation is not an option for the majority of patients. The aim of this study was to describe treatment practices, decision-making and symptoms during end-of-life care of IPF patients. METHODS: We identified 59 deceased patients from a national prospective IPF cohort study (FinnishIPF) and analyzed retrospectively their health care documentation during the 6 months that preceded death...
October 12, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27716183/development-of-a-video-based-education-and-process-change-intervention-to-improve-advance-cardiopulmonary-resuscitation-decision-making
#12
Nicholas Waldron, Claire E Johnson, Peter Saul, Heidi Waldron, Jeffrey C Chong, Anne-Marie Hill, Barbara Hayes
BACKGROUND: Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. METHODS: Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature...
October 6, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27698520/re-staging-following-long-course-chemoradiotherapy-for-rectal-cancer-does-it-influence-management
#13
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/27687815/capecitabine-and-oxaliplatin-prior-and-concurrent-to-preoperative-pelvic-radiotherapy-in-patients-with-locally-advanced-rectal-cancer-long-term-outcome
#14
Viviane Hess, Ralph Winterhalder, Roger von Moos, Lucas Widmer, Priska Stocker, Monika Jermann, Richard Herrmann, Dieter Koeberle
BACKGROUND: The risk/benefit ratio of any treatment can only be fully assessed if long-term results of both efficacy and toxicity are taken into account. Whereas the combined modality treatment of locally advanced rectal cancer (LARC) has considerably improved prognosis, particularly with regard to local control, long-term results-including patient-reported outcomes-are underreported. PATIENTS AND METHODS: Patients with LARC treated within a multicenter single-arm phase II study were prospectively assessed for at least 5 years after surgery...
July 30, 2016: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/27666307/what-are-the-barriers-to-initiating-end-of-life-conversations-with-patients-in-the-last-year-of-life
#15
Alice Travers, Vanessa Taylor
INTRODUCTION: Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. METHOD: Six electronic databases were searched for potentially relevant records published between 2008 and 2015...
September 2, 2016: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/27650010/exploring-the-topics-discussed-during-a-conversation-card-game-about-death-and-dying-a-content-analysis
#16
Lauren Jodi Van Scoy, Jean M Reading, Allison M Scott, Cynthia Chuang, Benjamin H Levi, Michael J Green
CONTEXT: Substantive discussions between loved ones are necessary for effective advance care planning. Although multiple tools are currently in use for promoting conversations, the content and clinical relevance of the conversations they stimulate is unknown. OBJECTIVE: To describe the content and clinical relevance of conversations that occur during a nonfacilitated end-of-life conversation game. METHODS: Using convenience sampling, we scheduled adult volunteers to participate in an end-of-life conversation game (2-6 individuals per game; n = 68)...
September 17, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27622294/availability-of-advance-care-planning-documentation-for-older-emergency-department-patients-a-cross-sectional-study
#17
Timothy F Platts-Mills, Natalie L Richmond, Eric M LeFebvre, Sowmya A Mangipudi, Allison G Hollowell, Debbie Travers, Kevin Biese, Laura C Hanson, Angelo E Volandes
INTRODUCTION: Increasing advance care planning (ACP) among older adults is a national priority. Documentation of ACP in the electronic health record (EHR) is particularly important during emergency care. OBJECTIVE: We sought to characterize completion and availability of ACP among a subset of older patients at an academic emergency department (ED) with an integrated EHR. METHODS: In this cross-sectional study, patients were eligible if aged ≥80 years or aged 65-79 with ≥1 indicator of high risk for short-term mortality...
September 13, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27583398/pulse-oximetry-screening-for-critical-congenital-heart-disease-in-planned-out-of-hospital-births-and-the-incidence-of-critical-congenital-heart-disease-in-the-plain-community
#18
K K Miller, K S Vig, E M Goetz, G Spicer, A J Yang, J S Hokanson
OBJECTIVE: This study evaluated pulse oximetry screening (POS) for critical congenital heart disease (CCHD) in planned out of hospital births with special attention to births in Plain communities (Amish, Mennonite and similar). STUDY DESIGN: Wisconsin out of hospital births in 2013 and 2014 were evaluated. Care providers were supplied with and trained in the use of pulse oximeters for CCHD screening. State records were reviewed to identify deaths and hospital admissions due to CCHD in this population...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27561444/do-not-attempt-resuscitation-orders-for-people-with-intellectual-disabilities-dilemmas-and-uncertainties-for-id-physicians-and-trainees-the-importance-of-the-deliberation-process
#19
A M A Wagemans, H M J van Schrojenstein Lantman-de Valk, I M Proot, A M Bressers, J Metsemakers, I Tuffrey-Wijne, M Groot, L M G Curfs
BACKGROUND: Not much is known about Do-Not-Attempt-Resuscitation (DNAR) decision-making for people with intellectual disabilities (IDs). The aim of this study was to clarify the problems and pitfalls of non-emergency DNAR decision-making for people with IDs, from the perspective of ID physicians. METHODS: This qualitative study was based on semi-structured individual interviews, focus group interviews and an expert meeting, all recorded digitally and transcribed verbatim...
August 26, 2016: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/27552101/detailed-dietary-assessment-in-patients-with-inoperable-tumors-potential-deficits-for-nutrition-care-plans
#20
Nikoletta Vidra, Meropi D Kontogianni, Evaggelia Schina, Ioannis Gioulbasanis
Advanced cancer often results in reduced dietary intake; however, data on actual intake at the time of diagnosis are limited. In the present study, a detailed dietary intake assessment was performed in patients with metastatic lung and upper gastrointestinal cancer, before initiation of systemic therapy. Basic demographics and performance status (PS) were recorded. Nutritional status was evaluated through anthropometry, Mini Nutritional Assessment (MNA), and 3 nonconsecutive 24-hour dietary recalls. Of the 84 patients enrolled, 61...
October 2016: Nutrition and Cancer
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