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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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March 2020 List
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 2020 List
URL Address
<a href="https://pediatrics.aappublications.org/content/144/2_MeetingAbstract/455">https://pediatrics.aappublications.org/content/144/2_MeetingAbstract/455</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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What impedes timely pediatric palliative care consults? A preliminary report
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
The topic of the resource
child; conference abstract; education; female; human; major clinical study; male; medical staff; narrative; nurse; Palliative therapy; pediatric patient; quality of life; responsibility; terminal care
Creator
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Marell P; Gupta S; Goloff N; Sherva K
Description
An account of the resource
Background: Pediatric palliative care (PPC) provides support focused on comfort and wellbeing for patients with serious illness and their families and assists with difficult care decisions, aiming to align medical care with the goals and values of the patient and family. Studies have shown that despite the benefits of PPC, many patients do not benefit from timely consultation (Morita et al.). Little, however, is known about the reasons for this. Objective: The purpose of this QI project was to identify barriers to PPC to inform an intervention aimed at increasing timely consultations at our hospital. Methods: Our team surveyed members of the inter-professional healthcare team as well as patients/families to assess attitudes, knowledge, and barriers related to PPC. In addition, parents gave narrative feedback at a hospital parent advisory board meeting. Results: Survey of healthcare workers (n = 243) showed that nurses had the smallest percentage of very favorable opinions toward PPC (64%), with the NICU (65%) and the ED (57%) as the units reporting lowest in that category. Nurses also had the lowest percentage of “good” or “excellent” understanding of PPC (27%), with the NICU (29%) and the ED (29%) again reporting lowest in that category. Attitude was positively correlated with knowledge (figure 1): 93% of respondents who rated their understanding as excellent had a very favorable opinion of PPC. The top barriers to PPC consultation were not knowing whose responsibility it was to order a consultation (24%) and worry about undermining parental hope (19%). More than half (68%) of respondents indicated that they ask permission of the patient/family before ordering a PPC consultation. Respondents reported that PPC consultations generally occurred when curative interventions were no longer possible (37%) and during end-of-life care (24%). Survey of patients/families (n = 33) showed that only 30% had a confident understanding of PPC services and 55% had received information regarding PPC from medical staff. Seventy percent had a favorable view of PPC while 21% needed more information to form an opinion. Comments from the parent advisory board indicated that lack of information regarding PPC is the major barrier for PPC utilization for patients/families. Conclusions and future directions: These results indicate that attitudes toward PPC and lack of education regarding PPC are the most common barriers to timely PPC consultations. As well, lack of information is likely a major contributing factor to unfavorable attitudes. Our intervention will aim to improve knowledge about and thus attitudes toward PPC. With each intervention we will complete a Plan-Do-Study-Act (PDSA) cycle and evaluate its success in increasing timely PPC consultations, with the ultimate goal of improving quality of life and goal-oriented care for our pediatric patients.
Rights
Information about rights held in and over the resource
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).
2019
Child
conference abstract
Education
Female
Goloff N
Gupta S
Human
Major Clinical Study
Male
March 2020 List
Marell P
Medical Staff
Narrative
Nurse
Palliative Therapy
pediatric patient
Pediatrics
Quality Of Life
responsibility
Sherva K
Terminal Care
-
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
March 2020 List
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 2020 List
URL Address
<a href="https://pediatrics.aappublications.org/content/144/2_MeetingAbstract/458">https://pediatrics.aappublications.org/content/144/2_MeetingAbstract/458</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
A name given to the resource
Simulation and skills training for pediatric fellows: Improving confidence in high-stakes care at end of life
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
The topic of the resource
child; clinical article; conference abstract; controlled study; female; hematology; human; male; pain; resuscitation; simulation; skill; teaching; terminal care
Creator
An entity primarily responsible for making the resource
Kamrath H; Goloff N; Norbie E; Woll A
Description
An account of the resource
Background: End-of-life (EOL) care for a child is a high-stakes situation that requires careful planning and practice; there is only one chance to get it right. Additionally, distress is often high in those caring for dying children. Despite the fact that treating patients with life-threatening illnesses necessitates providing EOL care at some point, formal training and skills practice is not a routine part of pediatric subspecialty training. In contrast, resuscitation - another high-stakes situation - is a skill that is nearly always required for staff. Despite the clear need for good care at EOL, it is generally not recognized that there are distinct EOL skills that need deliberate training and practice. Simulation and skills-based training, similar to that used for resuscitation, can provide opportunities to learn and practice skills in a safe, controlled environment to equip the trainee for the real situation. Purpose: The objective of this study was to evaluate whether a half-day simulation and skills-based workshop was feasible, desirable and could improve perceived confidence of specific EOL skills of pediatric subspecialty fellows. Methods: Hematology-oncology, PICU and NICU fellows at a Midwest academic children’s hospital (n=19) in all years of training were invited to participate in a half-day EOL workshop. Pre-intervention anonymous knowledge and confidence surveys were given to fellows at the beginning of the workshop. The educational intervention consisted of a pre-briefing introduction, 2 immersive simulations done as a team, and an EOL skills station. There was a short debrief after each immersive simulation, and the day concluded with a formal debriefing as a large group. A post-intervention confidence survey was given to fellows at the immediate conclusion of the workshop. Results: All participating fellows (n=17) completed the workshop and surveys. While 82% reported having had ‘a great deal’ of good modeling from attendings on providing EOL care, only 12% reported having had ‘a great deal’ of specific training (i.e. formal teaching or observation) in providing EOL care. Prior to the workshop, 53% of fellows agreed with the statement: “Overall, I feel confident about my ability to provide EOL care to patients.” After the workshop, 88% of fellows agreed or strongly agreed with this statement (Figure 1). For each of the 7 specific EOL care abilities surveyed, fellows’ collective self-reported confidence increased after the workshop, with the exception of the “...ability to address difficult questions (e.g. pain, process of dying, etc.) honestly and compassionately” (Figure 2). Conclusion: Simulation and skills training is an effective and desirable way to teach, practice and integrate skills in EOL care, and can be done in a half-day workshop.
Rights
Information about rights held in and over the resource
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).
2019
Child
Clinical Article
conference abstract
Controlled Study
Female
Goloff N
Hematology
Human
Kamrath H
Male
March 2020 List
Norbie E
Pain
Pediatrics
Resuscitation
Simulation
Skill
Teaching
Terminal Care
Woll A