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Advanced care plan recording

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https://www.readbyqxmd.com/read/29335033/should-capacity-assessments-be-performed-routinely-prior-to-discussing-advance-care-planning-with-older-people
#1
Oleg Kiriaev, Emme Chacko, J D Jurgens, Meagan Ramages, Phillipa Malpas, Gary Cheung
BACKGROUND: People with dementia receive worse end of life care compared to those with cancer. Barriers to undertaking advanced care planning (ACP) in people with dementia include the uncertainty about their capacity to engage in such discussions. The primary aim of this study was to compare the Advance Care Planning-Capacity Assessment Vignette tool (ACP-CAV) with a semi-structured interview adapted from the MacArthur Competence Assessment Tool-Treatment (MacCAT-T). The secondary aim was to identify demographic and cognitive functioning variables that may predict whether a person has capacity to discuss ACP...
January 16, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29313129/characteristics-and-care-pathways-of-advanced-cancer-patients-in-a-palliative-supportive-care-unit-and-an-oncological-ward
#2
Sebastiano Mercadante, Paolo Marchetti, Claudio Adile, Amanda Caruselli, Patrizia Ferrera, Andrea Costanzi, Alessandra Casuccio
BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered...
January 8, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29302602/what-are-the-ethical-questions-raised-by-the-integration-of-intensive-care-into-advance-care-planning
#3
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
A major goal of intensive care units (ICUs) is to offer optimal management, but for many patients admitted to the ICU, they are unlikely to yield any lasting benefit. In this context, the ICU physician remains a key intermediary, particularly when a decision regarding possible limitation or withdrawal of life-sustaining therapy becomes necessary. The possibility of admission to the ICU, and the type of care the patient would like to receive there, should be integrated into the healthcare project in agreement with the patient, regardless of the stage of disease that the patient suffers from...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298109/the-progression-of-end-of-life-wishes-and-concordance-with-end-of-life-care
#4
Jennifer Hopping-Winn, Juliette Mullin, Laurel March, Michelle Caughey, Melissa Stern, Jill Jarvie
Since 2013, Kaiser Permanente Northern California has engaged in a systematic effort to elicit, document, and honor the care preferences of patients as they near the end of life. This is done through its Advanced Steps program, in which selected patients discuss their preferences for future medical care with their healthcare agent during a structured conversation with a trained advance care planning facilitator. The facilitator then translates the patient's wishes into an actionable medical order set using a Physician's Order for Life-Sustaining Treatment (POLST) form...
January 3, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29285042/treatment-patterns-and-outcomes-in-elderly-patients-with-metastatic-breast-cancer-a-multicenter-retrospective-study
#5
Jin Hyun Park, In Sil Choi, Ki Hwan Kim, Jin-Soo Kim, Kyung-Hun Lee, Tae-Yong Kim, Seock-Ah Im, Se Hyun Kim, Yu Jung Kim, Jee Hyun Kim
Purpose: Currently, there is little information regarding optimal treatment for metastatic breast cancer (MBC) in elderly patients. In this retrospective study, we examined a cohort of elderly patients with MBC receiving a range of treatments, in terms of demographic and clinicopathologic characteristics, treatment patterns, and outcomes. Methods: Patients aged 65 years and older, and diagnosed with MBC between 2003 and 2015, were identified from the databases of three academic hospitals in South Korea...
December 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/29258525/advancing-perinatal-patient-safety-through-application-of-safety-science-principles-using-health-it
#6
Jennifer Webb, Asta Sorensen, Samantha Sommerness, Beth Lasater, Kamila Mistry, Leila Kahwati
BACKGROUND: The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety. METHODS: Semi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality's (AHRQ's) Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation...
December 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29251766/handing-off-the-older-patient-improved-documentation-of-geriatric-assessment-in-transitions-of-care
#7
Ben A Blomberg, Rebekah C Mulligan, Stephen J Staub, Laura C Hanson, Margaret A Drickamer, Maureen C Dale
OBJECTIVES: To improve assessment and documentation of function, cognition, and advance care planning (ACP) in admission and discharge notes on an Acute Care of the Elderly (ACE) unit. DESIGN: Continuous quality improvement intervention with episodic data review. SETTING: ACE unit of an 866-bed academic tertiary hospital. PARTICIPANTS: Housestaff physicians rotating on the ACE unit (N = 31). INTERVENTION: Introduction of templated notes, housestaff education, leadership outreach, and posted reminders...
December 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29246693/advancing-learning-to-advance-pharmacy-practice
#8
Michael J Rouse, CoraLynn B Trewet, Kristin K Janke
OBJECTIVES: The objectives of this commentary are to: 1) describe advancements in the continuing professional development (CPD) model over the past decade; 2) detail an updated CPD cycle; and 3) describe how practitioners' adoption of the CPD approach may facilitate the advancement of pharmacy practice. SUMMARY: CPD is a self-directed, ongoing, systematic, and outcomes-focused approach to an individual's lifelong learning that is applied into practice. The 6 components of reflect, plan, learn, evaluate, apply, and record + review, described in a revised depiction of the CPD cycle, have evolved over the past 10 years alongside the evolution of the profession of pharmacy...
December 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29244986/breast-cancer-in-ghana-demonstrating-the-need-for-population-based-cancer-registries-in-low-and-middle-income-countries
#9
Abigail S Thomas, Kelley M Kidwell, Joseph K Oppong, Ernest K Adjei, Ernest Osei-Bonsu, Angela Boahene, Evelyn Jiggae, Kofi Gyan, Sofia D Merajver
Purpose Breast cancer, the most common cancer worldwide, is the leading cause of cancer mortality in Ghanaian women. Previous studies find Ghanaian women are diagnosed at a younger age and at more advanced stages (III and IV), and have tumors with characteristics similar to African American women. We sought to remedy gaps in knowledge about breast cancer survival in Ghana and its relation to demographic and biologic factors of the tumors at diagnosis to assist in cancer control and registration planning. Methods Individuals with a breast cancer diagnosis who sought care at Komfo Anokye Teaching Hospital from 2009 to 2014 were identified via medical records...
December 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29224990/the-shift-to-same-day-outpatient-joint-arthroplasty-a-systematic-review
#10
REVIEW
Jeffrey D Hoffmann, Nicholas A Kusnezov, John C Dunn, Nicholas J Zarkadis, Gens P Goodman, Richard A Berger
BACKGROUND: Hip and knee arthroplasties length of stay continues to shorten after advances in perioperative and intraoperative management, as well as financial incentives. Some authors have demonstrated good results with outpatient arthroplasty, but safety and general feasibility of such procedures remain unclear. Our hypothesis is that outpatient arthroplasty would demonstrate higher readmission and complication rates than inpatient arthroplasty. METHODS: We performed a systematic review of all publications on outpatient arthroplasty between January 1, 2000 and June 1, 2016...
November 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#11
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29217960/knowledge-management-implementation-and-the-tools-utilized-in-healthcare-for-evidence-based-decision-making-a-systematic-review
#12
REVIEW
Leila Shahmoradi, Reza Safadari, Worku Jimma
Background: Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Methods: Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare"...
September 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29206553/development-of-imminent-mortality-predictor-for-advanced-cancer-impac-a-tool-to-predict-short-term-mortality-in-hospitalized-patients-with-advanced-cancer
#13
Kerin Adelson, Donald K K Lee, Salimah Velji, Junchao Ma, Susan K Lipka, Joan Rimar, Peter Longley, Teresita Vega, Javier Perez-Irizarry, Edieal Pinker, Rogerio Lilenbaum
PURPOSE: End-of-life care for patients with advanced cancer is aggressive and costly. Oncologists inconsistently estimate life expectancy and address goals of care. Currently available prognostication tools are based on subjective clinical assessment. An objective prognostic tool could help oncologists and patients decide on a realistic plan for end-of-life care. We developed a predictive model (Imminent Mortality Predictor in Advanced Cancer [IMPAC]) for short-term mortality in hospitalized patients with advanced cancer...
December 5, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29197046/evaluation-of-nutritional-status-post-laparoscopic-sleeve-gastrectomy-5-year-outcomes
#14
Salman Al-Sabah, Aliaa Al-Mutawa, Alfred Kojo Anderson, Mohammad Al-Mutawa
INTRODUCTION: Obesity is considered a public health problem and has led to advancements in bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) had become the most performed procedure worldwide; however, its consequences on nutritional status in the short and long term are of concern. METHODS: A retrospective analysis of medical records and bariatric database of patients who underwent LSG from October 2008-September 2015 at Al-Amiri Hospital, Kuwait, was performed...
December 1, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29193781/impact-of-tumour-motion-compensation-and-delineation-methods-on-fdg-pet-based-dose-painting-plan-quality-for-nsclc-radiation-therapy
#15
Hannah Mary Thomas, Paul E Kinahan, James Jebaseelan E Samuel, Stephen R Bowen
INTRODUCTION: To quantitatively estimate the impact of different methods for both boost volume delineation and respiratory motion compensation of [18F] FDG PET/CT images on the fidelity of planned non-uniform 'dose painting' plans to the prescribed boost dose distribution. METHODS: Six locally advanced non-small cell lung cancer (NSCLC) patients were retrospectively reviewed. To assess the impact of respiratory motion, time-averaged (3D AVG), respiratory phase-gated (4D GATED) and motion-encompassing (4D MIP) PET images were used...
November 28, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29191762/aprn-conducted-medication-reviews-for-long-stay-nursing-home-residents
#16
Amy Vogelsmeier, Lori Popejoy, Charles Crecelius, Sabrina Orique, Greg Alexander, Marilyn Rantz
OBJECTIVE: As part of the Missouri Quality Initiative (MOQI) to reduce hospitalizations for long-stay nursing home residents, this article describes reasons MOQI advanced practice registered nurses (APRNs) recommended medication order changes as part of their medication review process as well as the outcomes of their recommendations. DESIGN: Cross-sectional descriptive study of MOQI APRN-conducted medication reviews. SETTING: Long-stay nursing homes participating in the MOQI project...
November 28, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29182402/individual-versus-interprofessional-team-performance-in-formulating-care-transition-plans-a-randomised-study-of-trainees-from-five-professional-groups
#17
Timothy W Farrell, Katherine P Supiano, Bob Wong, Marilyn K Luptak, Brenda Luther, Troy C Andersen, Rebecca Wilson, Frances Wilby, Rumei Yang, Ginette A Pepper, Cherie P Brunker
Health professions trainees' performance in teams is rarely evaluated, but increasingly important as the healthcare delivery systems in which they will practice move towards team-based care. Effective management of care transitions is an important aspect of interprofessional teamwork. This mixed-methods study used a crossover design to randomise health professions trainees to work as individuals and as teams to formulate written care transition plans. Experienced external raters assessed the quality of the written care transition plans as well as both the quality of team process and overall team performance...
November 28, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29178895/informed-advance-refusals-of-treatment-by-people-with-severe-mental-illness-in-a-randomised-controlled-trial-of-joint-crisis-plans-demand-content-and-correlates
#18
Claire Henderson, Simone Farrelly, Clare Flach, Rohan Borschmann, Max Birchwood, Graham Thornicroft, Waquas Waheed, George Szmukler
BACKGROUND: In the UK, crisis planning for mental health care should acknowledge the right to make an informed advance treatment refusal under the Mental Capacity Act 2005. Our aims were to estimate the demand for such treatment refusals within a sample of service users who had had a recent hospital admission for psychosis or bipolar disorder, and to examine the relationship between refusals, and service user characteristics. METHODS: To identify refusals we conducted content analysis of Joint Crisis Plans, which are plans formulated by service users and their clinical team with involvement from an external facilitator, and routine care plans in sub-samples from a multi-centre randomised controlled trial of Joint Crisis Plans (plus routine mental health care) versus routine care alone (CRIMSON) in England...
November 24, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29172683/new-technique-of-percutaneous-ct-fluoroscopy-guided-marking-before-video-assisted-thoracoscopic-surgery-for-small-lung-lesions-feasibility-of-using-a-25-gauge-needle-without-local-anesthesia
#19
Yasuteru Shimamura, Shigeru Sasaki, Masashi Shimohira, Hiroyuki Ogino, Daisuke Yuki, Katsumi Nakamae, Masaki Hara, Yuta Shibamoto
OBJECTIVE: To retrospectively evaluate the feasibility of CT fluoroscopy-guided percutaneous marking using a 25-gauge needle and indigo carmine before video-assisted thoracoscopic surgery (VATS) for small lung lesions. METHODS: Twenty-one patients, 14 males and 7 females, with a median age of 69 years (range, 40-79), underwent CT fluoroscopy-guided percutaneous VATS marking using a 25-gauge, 70-mm needle and 1.5 ml indigo carmine. The mean diameter of the lung lesions was 14 mm (range, 6-27)...
November 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29166904/behaviors-in-advance-care-planning-and-actions-survey-bacpacs-development-and-validation-part-1
#20
Aliya Kassam, Maureen L Douglas, Jessica Simon, Shannon Cunningham, Konrad Fassbender, Marta Shaw, Sara N Davison
BACKGROUND: Although advance care planning (ACP) is fairly well understood, significant barriers to patient participation remain. As a result, tools to assess patient behaviour are required. The objective of this study was to improve the measurement of patient engagement in ACP by detecting existing survey design issues and establishing content and response process validity for a new survey entitled Behaviours in Advance Care Planning and ACtions Survey (BACPACS). METHODS: We based our new tool on that of an existing ACP engagement survey...
November 22, 2017: BMC Palliative Care
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