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Dublin Core
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Title
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January 2019 List
Text
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January 2019 List
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<a href="http://doi.org/10.1177/1049909118760303" target="_blank" rel="noreferrer noopener"> http://doi.org/ 10.1177/1049909118760303</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Provider Tools for Advance Care Planning and Goals of Care Discussions: A Systematic Review
Publisher
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American Journal of Hospice and Palliatice Care
Date
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2018
Subject
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advance care planning; Age Factors; Physician-Patient Relations; Communication; Advance Care Planning/standards; Humans; Pediatrics; palliative care; decision-making; systematic review; serious illness; Practice Guidelines as Topic; Geriatrics; goals of care discussions; Patient Care Planning/standards; point-of-care clinical tools
Creator
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Myers J; Cosby R; Gzik D; Harle I; Harrold D; Incardona N; Walton T
Description
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BACKGROUND: Advance care planning and goals of care discussions involve the exploration of what is most important to a person, including their values and beliefs in preparation for health-care decision-making. Advance care planning conversations focus on planning for future health care, ensuring that an incapable person's wishes are known and can guide the person's substitute decision maker for future decision-making. Goals of care discussions focus on preparing for current decision-making by ensuring the person's goals guide this process. AIM: To provide evidence regarding tools and/or practices available for use by health-care providers to effectively facilitate advance care planning conversations and/or goals of care discussions. DATA SOURCES: A systematic review was conducted focusing on guidelines, randomized trials, comparative studies, and noncomparative studies. Databases searched included MEDLINE, EMBASE, and the proceedings of the International Advance Care Planning Conference and the American Society of Clinical Oncology Palliative Care Symposium. CONCLUSIONS: Although several studies report positive findings, there is a lack of consistent patient outcome evidence to support any one clinical tool for use in advance care planning or goals of care discussions. Effective advance care planning conversations at both the population and the individual level require provider education and communication skill development, standardized and accessible documentation, quality improvement initiatives, and system-wide coordination to impact the population level. There is a need for research focused on goals of care discussions, to clarify the purpose and expected outcomes of these discussions, and to clearly differentiate goals of care from advance care planning.
Identifier
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<a href="http://doi.org/10.1177/1049909118760303" target="_blank" rel="noreferrer noopener">10.1177/1049909118760303</a>
2018
Advance Care Planning
Advance Care Planning/standards
Age Factors
American Journal of Hospice and Palliatice Care
Communication
Cosby R
Decision-making
Geriatrics
goals of care discussions
Gzik D
Harle I
Harrold D
Humans
Incardona N
January 2019 List
Myers J
Palliative Care
Patient Care Planning/standards
Pediatrics
Physician-patient Relations
point-of-care clinical tools
Practice Guidelines As Topic
Serious Illness
Systematic Review
Walton T
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
March 2016 List
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Compassionate Extubation For A Peaceful Death In The Setting Of A Community Hospital: A Case-series Study
Publisher
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Clinical Interventions In Aging
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
Subject
The topic of the resource
Geriatrics & Gerontology; Life; Quality Of Death; Withdrawal; Intensive-care-unit; Palliative Care; Palliative Extubation; Good Death; Mechanical Ventilation; Support; End; Compassionate Extubation; Euthanasia; Hospice Care; Murder; Terminal Care/methods; Airway Extubation - Methods; Hospitals; Community - Organization & Administration; Geriatrics; Compassionate Extubation; Rc952-954.6
Compassionate Extubation; Palliative Extubation; Good Death; Hospice Care; Quality Of Death
Creator
An entity primarily responsible for making the resource
Victor C Kok
Description
An account of the resource
Background
The use of compassionate extubation (CE) to alleviate suffering by terminating mechanical ventilation and withdrawing the endotracheal tube requires professional adherence and efficiency. The Hospice Palliative Care Act, amended on January 9, 2013, legalizes the CE procedure in Taiwan.
Methods
From September 20, 2013 to September 2, 2014, the hospice palliative care team at a community hospital received 20 consultations for CE. Eight cases were excluded because of non-qualification. Following approval from the Ethics Committee, the medical records of the remaining 12 patients were reviewed and grouped by the underlying disease: A, “terminal-stage cancer”; B, “non-cancer out-of-hospital cardiac arrest”; and C, “non-cancer organ failure”. Time to extubation using a cut-off at 48 hours was assessed.
Results
The mean ages of patients (standard deviation) in groups A, B, and C were 66.3 (14.9) years, 72 (19.1) years, and 80.3 (4.0) years, respectively. The mean number of days of intubation at consultation were 6.8 (4.9), 7.3 (4.9), and 179.3 (271.6), respectively. The mean total doses of opioids (as morphine-equivalent dose) in the 24 hours preceding CE were 76 (87.5) mg, 3.3 (5.8) mg, and 43.3 (15.3) mg. The median times from extubation (range) to death were 97 (0.2–245) hours, 0.3 (0.2–0.4) hours, and 6.1 (3.6–71.8) hours. Compared to those requiring <48-hour preparatory time, patients requiring >48 hours to the moment of CE were younger (62.8 years vs 75.5 years), required a mean time of 122 hours (vs 30 hours) to CE (P=0.004), had shorter length of stay (33.3 days vs 77.8 days), required specialist social worker intervention in 75% of cases (vs 37.5%), and had a median duration of intubation of 11.5 days (vs 5.5 days).
Conclusion
CE was carried out according to protocol, and the median time from extubation to death varies determined by the underlying disease which was 0.3 hour in patients admitted after out-of-hospital cardiac arrest and 97 hours in patients with advanced cancer.
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2016
Airway Extubation - Methods
Clinical Interventions in Aging
Community - Organization & Administration
Compassionate Extubation
End
Euthanasia
Geriatrics
Geriatrics & Gerontology
Good Death
Hospice Care
Hospitals
Intensive-care-unit
Life
March 2016 List
Mechanical Ventilation
Murder
Palliative Care
Palliative Extubation
Quality Of Death
Rc952-954.6
Support
Terminal Care/methods
Victor C Kok
Withdrawal