Place of death and palliative care following discharge from paediatric intensive care units
Child; Female; Humans; infant; Male; Intensive Care Units; Cohort Studies; adolescent; Preschool; infant; Newborn; Hospitalization/statistics & numerical data; Palliative Care/statistics & numerical data; location of death; Pediatric/statistics & numerical data; child mortality; Great Britain/epidemiology; Home Care Services/statistics & numerical data; Hospice Care/statistics & numerical data; Patient Discharge/statistics & numerical data; Referral and Consultation/statistics & numerical data
OBJECTIVE: To determine where children die following discharge from paediatric intensive care units (PICUs) in Great Britain and to investigate if this varies by discharge to palliative care. DESIGN: National cohort of PICU admissions linked to Office of National Statistics death certificate data. SETTING: 31 PICUs in Great Britain. PARTICIPANTS: A cohort of 35 383 children admitted to PICUs between 1 November 2002 until 25 January 2007. MAIN OUTCOME MEASURES: Place of death by palliative care discharge status. RESULTS: 2346 (6.6%) deaths occurred after discharge during the study period, which is more than 10 times the normal child population mortality of 6.0 per 1000. Discharge to palliative care resulted in fewer deaths in hospital (44.1%) (compared to non-palliative care discharges (77.7%)), a greater proportion of deaths were at home (33.3% compared to non-palliative discharges 16.1%) and in a hospice (22.5% compared to non-palliative discharges 5.8%). CONCLUSIONS: Children referred to palliative care services at discharge from PICU are more likely to die in the community (home or hospice) than children not referred to palliative care.
Fraser LK; Miller M; Draper ES; McKinney PA; Parslow RC; Paediatric Intensive Care Audit Network
Archives Of Disease In Childhood
2011
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).
Journal Article
<a href="http://doi.org/10.1136/adc.2009.178269" target="_blank" rel="noreferrer">10.1136/adc.2009.178269</a>
Staff Efficiency Trends Among Pediatric Hospices, 2002-2011.
Adolescent; California; Child; Child Preschool; Efficiency Organizational/statistics & Numerical Data; Female; Forecasting; Hospice Care/statistics & Numerical Data; Hospice Care/trends; Hospice Care/statistics & Numerical Data; Hospices/trends; Hospitals Pediatric/statistics & Numerical Data; Hospitals Pediatric; Humans; Infant; Infant Newborn; Male; Personnel Staffing And Scheduling/statistics & Numerical Data; Personnel Staffing And Scheduling/trends; Workload/statistics & Numerical Data; Young Adult
This study provided the first examination of staff efficiency trends among pediatric hospices. Although pediatric staff efficiency demonstrated large variability from 2002 to 2011, the general trend in efficiency from 2003 to 2010. The decline in efficiency means, on average, pediatric hospices had higher operating expenses and used more capacity, but greater amounts of these greater outputs as measured by visits per patient. The study also highlights the crucial role pediatric hospice nurse managers play in developing effective workforce strategies that allow for responsive changes to workload fluctuations. Due to the associations between efficiency, regulation, and growth, nurse leaders' abilities to develop effective strategies are more imperative than ever to ensure quality end-of-life care for children and their families.
Cozad MJ; Lindley LC; Mixer SJ
Nursing Economic$
2016
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).
PMCID: PMC5045247
Mortality trends for pediatric life-threatening conditions.
Pediatrics; Adolescent; British Columbia; Cause Of Death; Child; Child Mortality/trends; Child Preschool; Female; Hospice; Hospice Care/statistics & Numerical Data; Humans; Illness; Infant; Infant Newborn; Life-threatening Conditions; Male; Mortality; Palliative; Palliative Care/statistics & Numerical Data; Pediatric
Internal data from the sole pediatric hospice in British Columbia were utilized to investigate mortality trends among children dying from life-threatening conditions. Characteristics of the sample (hospice) were compared to that of the population (province) for individuals aged 0 to 18 years from 2002 to 2011. The provincial death rate was 2.30 per 10 000. The sample did not significantly vary with respect to sex and geographic distribution when compared to the population. Infants contributed to a significantly larger proportion of pediatric deaths in the population. Children referred to the hospice were more likely to be diagnosed with cancer and diseases of the nervous system. Only 15% of all pediatric deaths due to disease in the province were cared for by the hospice, calling for the strengthening of interdisciplinary palliative care programs.
Chavoshi N; Miller T; Siden H
The American Journal Of Hospice & Palliative Care
2014
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).
<a href="http://doi.org/10.1177/1049909114524476" target="_blank" rel="noreferrer">10.1177/1049909114524476</a>