Browse Items · Pediatric Palliative Care Library

‘Do Not Attempt Resuscitation’ – Do Standardised Order Forms make a clinical difference above hand-written note entries?

SummaryAim To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for ‘Do Not Attempt Resuscitation’ – on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. Methods A…

Tags: 2009, Advance Directives, Backlog, Cardiopulmonary Resuscitation, DNAR, DNAR Outcomes, Edwards VM, Hall S, Hutchings H, Journal Article, Lewis KE, Patient Selection, Resuscitation, Routine data, Temblett P

A pilot study of palliative medicine fellows' hospice home visits.

This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify…

Advance directives and do-not-resuscitate orders in patients with cancer with metastatic spinal cord compression: advanced care planning implications.

OBJECTIVES: Communication about end-of-life decisions is crucial. Although patients with metastatic spinal cord compression (MSCC) have a median survival time of 3 to 6 months, few data are available concerning the presence of advance directives and…

Advance directives in a pediatric emergency department.

Parents of children with terminal illnesses are not always present when a life-threatening event occurs. For many of these children, an advance directive specifying alternate code orders has been written by the parent or legal guardian (hereafter the…

Advanced care planning in children with life-limiting conditions – the Wishes Document

Alterations in end-of-life support in the pediatric intensive care unit.

OBJECTIVE: Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs., METHODS: This was a retrospective, descriptive study. Variables collected included end-of-life support category, race, length of stay,…

Tags: 2010, Advance Directives, Backlog, Brain Death, Child, DNAR, Humans, Intensive Care Units, Journal Article, Lee KJ, Life Support Care, Pediatric, Pediatrics, Resuscitation Orders, Scanlon MC, Terminal Care, Tieves K, Withholding Treatment

An advance directive in two questions.

It has been two decades since advance directives have become an integral part of health care. Impediments to their optimal usage are common and multifactorial. Decisions commonly have to be made when patients are unable to do so or choose not to…

Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.

The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care…

Attitudes of adolescent cancer survivors toward end-of-life decisions for minors.

OBJECTIVES: The present study aimed to investigate the attitudes of adolescent cancer survivors toward end-of-life decisions with life-shortening effects, including nontreatment decisions (NTDs), intensified alleviation of pain and symptoms (APS),…

Barriers to conducting advance care discussions for children with life-threatening conditions.

BACKGROUND AND OBJECTIVE: Advance care discussions (ACD) occur infrequently or are initiated late in the course of illness. Although data exist regarding barriers to ACD among the care of adult patients, few pediatric data exist. The goal of this…

Can't we improve on advance directives?.

2008

Tags: 2008, Advance Care Planning/st [Standards], Advance Directives, Annals Of Internal Medicine, Backlog, Brasic GM, Decision Making, DNAR, Documentation, Family, Hammes BJ, Humans, Journal Article, Medical Records, Palliative Care/st [standards], Patients/px [psychology]

Cardiopulmonary resuscitation in patients with cancer.

Cancer is the second leading cause of death in the United States, with most of these deaths taking place in the hospital setting. Discussions on end-of-life care and on cardiopulmonary resuscitation in particular are an important component in the…

Tags: 2007, Backlog, Cardiopulmonary Resuscitation, Decision Making, DNAR, Humans, Journal Article, Marik PE, Neoplasms/th [therapy], Palliative Care, Quality Of Life, Resuscitation Orders, The American Journal of Hospice & Palliative Care, Varon J

Care for dying patients.

1997

Tags: 1997, Advance Care Planning, Advance Directives, Backlog, Communication, Decision Making, DNAR, Emanuel EJ, Euthanasia, Family, Humans, Journal Article, Lancet, Palliative Care, Passive, Physician-patient Relations, Physicians, Terminal Care, Withholding Treatment

Characteristics of patients who refuse do-not-resuscitate orders upon admission to an acute palliative care unit in a comprehensive cancer center.

BACKGROUND: Refusal of appropriately indicated do-not-resuscitate (DNR) orders may cause harm and distress for patients, families, and the medical team. We conducted a retrospective study to determine the frequency and predictors of refusals of DNR…

Communication and advanced care planning in palliative and end-of-life care.

Communication about and planning for the end of life has evolved with medical and technological changes. This article presents a focused literature review of Advance Directives (ADs), Advanced Care Planning (ACP), and communication in palliative and…

Tags: 2012, Advance Care Planning, Advance Directives, Backlog, Clinical Nursing Research, Communication, DNAR, Humans, Journal Article, Meeker MA, Nursing Outlook, Palliative Care, Terminal Care, United States, Waldrop DP

Determinants of do-not-resuscitate orders in palliative home care.

OVERVIEW: Do-not-resuscitate (DNR) orders allow home care clients to communicate their own wishes over medical treatment decisions, helping to preserve their dignity and autonomy. To date, little is known about DNR orders in palliative home care.…

Developing a policy for do not resuscitate orders within a framework of goals of care.

BACKGROUND: Discussions about DNR (do not resuscitate) orders or code status are common but can be difficult and may not lead to accurate understanding between clinicians and patients. These discussion are often isolated from the larger context of a…

Tags: 2011, Backlog, Broderick A, Decision Making, DNAR, Hospital Administration/es [Ethics], Humans, Joint Commission Journal On Quality And Patient Safety / Joint Commission Resources, Journal Article, Kaldjian LC, Palliative Care/es [Ethics], Palliative Care/og [Organization & Administration], Patient Care Planning/es [Ethics], Patient Care Planning/og [Organization & Administration], Policy, Resuscitation Orders/es [Ethics], Terminal Care/es [ethics], Terminal Care/og [organization & Administration]

Documenting end of life decisions in residential aged care facilities in South Australia.

OBJECTIVE: This research examined the provision of palliative care for residents with a non-cancer diagnosis including the use of advance directives and advance care planning as part of palliative care policies in residential aged care facilities in…

Easing of suffering in children with cancer at the end of life: is care changing?.

PURPOSE: In the past decade studies have documented substantial suffering among children dying of cancer, prompting national attention on the quality of end-of-life care and the development of a palliative care service in our institutions. We sought…

End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making.

This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions…

Ethnicity, race, and advance directives in an inpatient palliative care consultation service.

OBJECTIVE: Although race and ethnic background are known to be important factors in the completion of advance directives, there is a dearth of literature specifically investigating the effect of race and ethnicity on advance directive completion rate…

Tags: 2013, 80 And Over, Adult, Advance Directives/eh [Ethnology], African Americans/statistics & numerical data, Aged, Asian Continental Ancestry Group/sn [Statistics & Numerical Data], Attitude to Death/eh [Ethnology], Backlog, Cooper LB, Cross-cultural Comparison, Decision Making, DNAR, European Continental Ancestry Group/sn [Statistics & Numerical Data], Female, Hispanic Americans/sn [Statistics & Numerical Data], Humans, Journal Article, Lesser ML, Liberman T, Male, Middle Aged, Mir Tanveer P, New York/ep [Epidemiology], Nouryan CN, Palliative & Supportive Care, Palliative Care/og [Organization & Administration], Pekmezaris R, Program Evaluation, Referral and Consultation/og [Organization & Administration], Resuscitation Orders, Sison CP, Spirituality, Terminal Care/og [organization & Administration], Wolf-Klein GP, Zaide GB

Experience in the use of the palliative care outcome scale.

GOALS OF WORK: The objective of the study is to assess the Palliative Care Outcome Scale (POS) as a potential audit tool within a specialist cancer centre. It also aims to answer the following questions: does the tool identify problem areas and…

Finding the right words: using the terms allow natural death (AND) and do not resuscitate (DNR) in pediatric palliative care.

When children are dying in a hospital setting, healthcare providers need to help families make important end-of-life care decisions. Most providers use the term do not resuscitate (DNR) when suggesting a course of action that involves not using…

Hospital care of patients with dementia.

How children die in hospital.

A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236…

Impact of a palliative care initiative on end-of-life care in the general wards: A before-and-after study._

BACKGROUND: Data on deaths in the general wards of our hospital in 2007 revealed infrequent discussions on end-of-life care and excessive burdensome interventions., AIM: A physician order form to withhold inappropriate life-sustaining interventions…

Tags: 2014, Advance Care Planning/st [Standards], Advance Care Planning/standards, Aged, Asian, Backlog, Cardiopulmonary Resuscitation, Chronic Disease/ep [Epidemiology], Chronic Disease/epidemiology, Chronic Disease/th [Therapy], Chronic Disease/therapy, Chua G, Clinical Audit, Comorbidity, DNAR, DNAR Outcomes, Do-not-resuscitate Orders, Female, Forms and Records Control, general wards, Hospital Mortality/td [Trends], Hospital Mortality/trends, Humans, Journal Article, Life Support Care/methods, Life Support Care/mt [Methods], Life Support Care/sn [Statistics & Numerical Data], Life Support Care/statistics & numerical data, Lim Tow K, Logistic Models, Male, Palliative Care, Palliative Medicine, Patient Admission/statistics & numerical data, Patient Admission/td [Trends], Patient Admission/trends, Phua J, Program Evaluation, Resuscitation Orders, Retrospective Studies, Seah A, Singapore/ep [Epidemiology], Singapore/epidemiology, Social Class, Tan A, Withholding Treatment/sn [statistics & Numerical Data], Withholding Treatment/statistics & Numerical Data

Impact of an inpatient palliative care team: a randomized control trial.

BACKGROUND: Palliative care improves care and reduces costs for hospitalized patients with life-limiting illnesses. There have been no multicenter randomized trials examining impact on patient satisfaction, clinical outcomes, and subsequent health…

Tags: 2008, Advance Directives/sn [Statistics & Numerical Data], Advance Directives/statistics & Numerical Data, Aged, Backlog, Beane J, Blum M, Conner D, Cooperative Behavior, Critical Illness/ep [Epidemiology], Critical Illness/epidemiology, Critical Illness/psychology, Critical Illness/px [psychology], Critical Illness/rehabilitation, Critical Illness/rh [Rehabilitation], Della PR, DNAR, DNAR Outcomes, Gade G, Hospice Care/ut [Utilization], Hospice Care/utilization, Hospitalization, Hospitalization/statistics & numerical data, Humans, Journal Article, Journal of Palliative Medicine, Liberson M, McGrady K, Palliative Care/methods, Palliative Care/mt [methods], Patient Care Team, Patient Satisfaction, Prospective Studies, Quality Of Life/psychology, Quality Of Life/px [psychology], Richardson RH, Survival Rate, Venohr I, Williams MP

Impact of writing "comfort measures only" orders in a community teaching hospital.

OBJECTIVES: We compared end-of-life care for patients with and without orders for "comfort measures only" (CMO) and evaluated whether standards for palliative medicine were met., DESIGN: We retrospectively reviewed the charts of 40 patients, 20 with…

Integrating POLST into palliative care guidelines: a paradigm shift in advance care planning in oncology.

Because predicting and outlining guidance for all possible scenarios is difficult, advance directives are rarely sufficiently precise to dictate patient preferences in specific situations as a disease progresses. Nonetheless, advance care planning is…

Tags: 2006, Advance Care Planning, Advance Directives, Backlog, Bomba Patricia A, Decision Making, DNAR, Humans, Journal Article, Journal Of The National Comprehensive Cancer Network, Life Support Care/st [Standards], Medical Oncology, Neoplasms/px [psychology], Neoplasms/th [therapy], Palliative Care, Physician's Practice Patterns/og [Organization & Administration], Vermilyea D

Intensive care unit palliative medicine: some issues-part II.

Tags: 2011, Backlog, DNAR, Enck RE, Health Care Rationing/ec [economics], Health Care Rationing/og [Organization & Administration], Humans, Intensive Care Units/ec [Economics], Intensive Care Units/og [Organization & Administration], Journal Article, Medical, Palliative Care/ec [economics], Palliative Care/og [Organization & Administration], Resuscitation Orders, Sociology, The American Journal of Hospice & Palliative Care

Is an advance care planning model feasible in community palliative care? A multi-site action research approach.

AIM: This article reports a study to determine the feasibility of an advance care planning model developed with Australian community palliative care services., BACKGROUND: An effective advance care planning programme involves an organizational wide…

Mind the child: using interactive technology to improve child involvement in decision making about life-limiting illness.

Palliative medicine consultation for preparedness planning in patients receiving left ventricular assist devices as destination therapy.

OBJECTIVE: To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT)., PATIENTS AND METHODS:…

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients.

OBJECTIVE: The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who…

Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.

PURPOSE: Many seriously ill patients with cancer do not discuss prognosis or advance directives (ADs), which may lead to inappropriate and/or unwanted aggressive care at the end of life. Ten years ago, patients with cancer said they would not like to…

Parent resuscitation preferences for young people with severe developmental disabilities.

OBJECTIVE: To determine the relationship of providing explanatory information regarding resuscitation to DNR status for parents and guardians of young people who reside in a pediatric skilled nursing facility., DESIGN: Retrospective,…

Tags: 2006, Adolescent, Adult, Advance Care Planning/og [Organization & Administration], Advance Care Planning/organization & Administration, Analysis of Variance, Attitude To Health, Backlog, Child, Choice Behavior, Consent Forms, Developmental Disabilities/co [Complications], Developmental Disabilities/complications/therapy, Developmental Disabilities/th [Therapy], DNAR, Documentation, Female, Friedman SL, Health Education/og [Organization & Administration], Health Education/organization & administration, Humans, Journal Article, Journal Of The American Medical Directors Association, Male, Massachusetts, Organizational Policy, Parents, Parents/ed [education], Parents/education/psychology, Parents/px [psychology], Preschool, Program Evaluation, Resuscitation Orders/psychology, Resuscitation Orders/px [Psychology], Retrospective Studies, Skilled Nursing Facilities/og [Organization & Administration], Skilled Nursing Facilities/organization & administration, Treatment Refusal/psychology, Treatment Refusal/px [Psychology]

Pediatric Advance Care Planning: A Systematic Review

BACKGROUND AND OBJECTIVES: Advance care planning (ACP) is increasingly regarded as the gold standard in the care of patients with life-limiting illnesses. Research has focused on adults, but ACP is also being practiced in pediatrics. We conducted a…

Pediatric advance care planning.

OBJECTIVE: This study describes the process and population involved in pediatric advance care planning at one Midwest medical center. The outcomes and the parents' perceptions of this planning are also discussed., METHODS: Pediatric patients with…

Tags: 2005, 7 died at home and 2 died at a hospital. Eight of the children's advance directives were followed during the dying process, 9 are deceased, Advance Care Planning/og [Organization & Administration], Advance Care Planning/organization & Administration, Backlog, Child, DNAR, DNAR Outcomes, Female, Hammes BJ, Humans, including preserving their child's quality of life and avoiding unnecessary suffering., individuals in the community raised concerns about the child's advance directive. CONCLUSIONS: Even though the topic of their child's death is difficult, Infant, Interviews As Topic, Journal Article, Journal of Palliative Medicine, Kempf M, Klevan J, Male, Newborn, Parents/psychology, Parents/px [psychology], Pediatrics, PedPal Lit, Preschool, the majority of the interviewed parents found the advance care planning process for the child helpful because it assured the best care for the child, while 1 was not. Th irteen parents were interviewed. Twelve stated that the process of advance care planning benefited their children and their family. Rarely, Williams MS, Wisconsin

Pediatric advance directives: parents' knowledge, experience, and preferences

OBJECTIVES: To explore parents' and caregivers' experience, knowledge, and preferences regarding advance directives (ADs) for children who have chronic illness. METHODS: We conducted a prospective, cross-sectional survey of parents and caregivers of…

Pediatric palliative care.

Palliative care has always been a part of the care of children. It includes any intervention that focuses on relieving suffering, slowing the progression of disease, and improving quality of life at any stage of disease. In addition, for even the…

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