Browse Items · Pediatric Palliative Care Library

Withdrawal and limitation of life-sustaining treatments in a paediatric intensive care unit and review of the literature.

OBJECTIVES: To examine withdrawal and limitation of life-sustaining treatment (WLST) in an Australian paediatric intensive care unit (PICU) and to compare this experience with published data from other countries. DESIGN: Retrospective chart review…

Why Are There So Few Ethics Consults in Children's Hospitals?

In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that…

Validation of a decision rule identifying febrile young girls at high risk for urinary tract infection

OBJECTIVE: To validate a previously published clinical decision rule to predict risk of urinary tract infection in febrile young girls. METHODS: We performed a retrospective case-control study at a children's hospital emergency department in a…

Utilization and costs for children who have special health care needs and are enrolled in a hospital-based comprehensive primary care clinic

OBJECTIVE: When deciding how much hospital resources should be allocated to comprehensive primary care clinics for children with multisystem disorders, it is important to consider all of the non-primary care revenue streams associated with these…

Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States

OBJECTIVE: To evaluate the use of healthcare resources during the last six months of life among patients of US hospitals with strong reputations for high quality care in managing chronic illness. DESIGN: Retrospective cohort study based on claims…

Unlicensed and off label analgesic use in paediatric pain management

BACKGROUND: The management of pain in children has advanced enormously in recent years. Pharmacological treatment of pain is complicated however, by the widespread use of unlicensed and off label medicines in the paediatric population, leading to…

Tags: 2001, Analgesics/therapeutic use, Backlog, Child, Conroy S, Drug Approval, Drug Utilization, Great Britain, Hospitals, Humans, Journal Article, Paediatric Anaesthesia, Pain/drug Therapy, Peden V, Pediatric, Prospective Studies

Unique aspects of caring for dying children and their families

Pediatric hospice has become an important service for children and their families in the past decade. In this article we present unique aspects of StarShine, the hospice of Children's Hospital Medical Center in Cincinnati, Ohio. Length-of-service…

Transition of care: health care professionals' view

There is much anxiety regarding the transfer of adolescents with chronic illness to adult services. Transfer of patients can be haphazard if the transition has not been planned. Problems and obstacles to transition have been identified and discussed…

Transition in chronic illness: Who is going where?

AIM: With increasing survival rates for chronic childhood illness, there has been an increasing focus on the transition of clinical care from paediatric to adult services. Data regarding patient numbers are essential for strategic planning and for…

Tags: 2008, Adolescent, Adolescent Medicine, Adolescent Transitions, Backlog, Brodie L, Child, Chronic Disease/epidemiology/therapy, Continuity Of Patient Care/organization & Administration, Delivery of Health Care/organization & administration, Hospitals, Humans, Interviews As Topic, Journal Article, Journal of Paediatrics and Child Health, New South Wales/epidemiology, Pediatric, Steinbeck KS, Towns SJ

The moral experience of parents regarding life-support decisions for their critically-ill children: a preliminary study in France

The common paediatric critical care practice in France is for physicians (rather than parents) to maintain the ultimate responsibility for lifesupport decisions in children. Some French literature asserts that it is inappropriate for parents to bear…

The effect of inpatient hospice units on hospice use post-admission

The objective of this study was to determine whether having a hospice unit within the hospital increases the proportion of terminally ill patients who use hospice services (including home, nursing home, or inpatient hospice) post-admission. Using…

The costs and potential savings of a novel telepaediatric service in Queensland

BACKGROUND: There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person. METHODS: In November 2000,…

The benefits of a hospital-based inpatient palliative care consultation service: preliminary outcome data

This report describes the multiple complementary analytic methods used to create a composite evaluation of the benefits of a hospital-based inpatient palliative care consultation service at Montefiore Medical Center in its preliminary phase. We…

Supportive care: palliative care in children, adolescents, and young adults--model of care, interventions, and cost of care: a retrospective review

Status of pediatric pain control: a comparison of hospital analgesic usage in children and adults

A chart review was conducted of the records of 90 children and 90 adults, randomly selected and matched for sex and diagnosis, to investigate analgesic usage. Four diagnostic categories (hernias, appendectomies, burns, and fractured femurs) at two…

Tags: 1986, Adult, Age Factors, Allen DA, Analgesics/therapeutic use, Backlog, Child, Female, Hanson K, Hospitals, Human, Journal Article, Male, Palliative Care, Pediatric, Pediatrics, Preschool, Schechter NL

Standards of Hospice Care for Children

1993

Tags: 1993, Anonymous, Backlog, Children, Hospices, Hospitals, Journal Article, NET Grey Lit, Quality Of Health Care, Special

Siblings’ voices: A prospective investigation of experiences with a dying child

Sibling relationships reflect a unique childhood bond, thus the impact on a sibling when a child is seriously ill or dying is profound. We conducted a prospective, longitudinal, qualitative study over 2 years using interpretive descriptive…

Reviewing audit: barriers and facilitating factors for effective clinical audit

OBJECTIVE: To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. DESIGN: A comprehensive literature review was undertaken through a…

Review of pediatric autopsies performed at a university hospital in Ribeirao Preto, Brazil

CONTEXT: Autopsy continues to provide important data for quality assurance, teaching, scientific purposes, and health planning, especially if performed according to a comprehensive protocol. OBJECTIVE: To describe and analyze data from all perinatal…

Research participation experiences of parents of children with cancer who were asked about their child's prognosis

BACKGROUND: In questionnaire-based research, human subject protection committees must assess the emotional impact of the study on participants. Without clear data about the risks and benefits of participating in such studies, however, review board…

Promoting resilience among parents and caregivers of children with cancer

BACKGROUND: Promoting resilience is an aspect of psychosocial care that affects patient and whole-family well-being. There is little consensus about how to define or promote resilience during and after pediatric cancer. OBJECTIVES: The aims of this…

Preparing for an initial JCAHO survey: one hospice's experience

2001

Tags: 2001, American Journal of Hospice & Palliative Medicine, Backlog, Data Collection, Groves LE, Health Surveys, Hospices, Hospitals, Journal Article, Special

Pharmacological Management of Symptoms in Children with Life-Limiting

Background: The provision of pediatric palliative care in Asia Pacific varies between countries and availability of essential medications for symptoms at the end of life in this region is unclear. Objective: To determine medications available and…

Perinatal loss. A critique of current hospital practices

Dramatic improvements in the hospital management of perinatal loss have taken place in the past 20 years. However, there has been no critical examination of current approaches. Four possible hazards of current hospital practice are described: 1)…

Perceptions of the term palliative care

OBJECTIVES: To assess parents' and health care providers' perceptions of the name and description of a pediatric palliative care (PPC) program. METHODS: Survey conducted at three pediatric health care sites; asked respondents (parents and staff)…

Pediatric pain practices: a national survey of health professionals

The purpose of this study was to examine how health-care providers in U.S. teaching hospitals assess and manage children's pain. A 59-item questionnaire was sent to institutions with pediatric residency programs listed in the 1992 National Residency…

Tags: 1996, Alexander M, Backlog, Broome ME, Child, Hospitals, Humans, Journal Article, Journal of Pain and Symptom Management, Maikler V, Pain Measurement, Pain/therapy, Physician's Practice Patterns, Questionnaires, Richtsmeier A, Teaching, United States

Pediatric nurses' individual and group assessments of palliative, end-of-life, and bereavement care

BACKGROUND: Although pediatric nurses working in children's hospitals often provide care to dying children, little is known about their palliative care beliefs and experiences as individuals or members of groups within the hospital. OBJECTIVE: To…

Parents' perspectives on physician-parent communication near the time of a child's death in the pediatric intensive care unit

OBJECTIVE: Communicating bad news about a child's illness is a difficult task commonly faced by intensive care physicians. Greater understanding of parents' scope of experiences with bad news during their child's hospitalization will help physicians…

Parents' Perspectives on Hospital Care for Children and Adolescents with Life-Limiting Conditions: A Grounded Theory Analysis of Narrative Interviews

Background: Guidelines on pediatric palliative care recommend to provide care for children and adolescents with life-limiting conditions at home. Since 2007, in Germany, palliative home care can be provided by specialized outpatient palliative care…

Tags: 2019, 2022 Special Edition 1 - Parent Perspectives, Ambulatory Care, Engler F, Engler J, Erler A, Gerlach FM, Gruber D, Hach M, Hospitals, Journal of Palliative Medicine, Kuss K, Palliative Care, Parents, Pediatrics, Qualitative Research, Seipp H, Ulrich LR

Parents' Perspectives on Hospital Care for Children and Adolescents with Life-Limiting Conditions: A Grounded Theory Analysis of Narrative Interviews

Background: Guidelines on pediatric palliative care recommend to provide care for children and adolescents with life-limiting conditions at home. Since 2007, in Germany, palliative home care can be provided by specialized outpatient palliative care…

Tags: 2019, Ambulatory Care, Engler F, Engler J, Erler A, Gerlach F M, Gruber D, Hach M, Hospitals, January 2020 List, Journal of Palliative Medicine, Kuss K, Palliative Care, Parents, Pediatrics, Qualitative Research, Seipp H, Ulrich L R

Parental perspectives on hospital staff members' acts of kindness and commemoration after a child's death

OBJECTIVES: Acts of kindness and commemoration by staff members often follow the death of a patient. Acts include attending funerals, sending sympathy cards, sending cards on birthdays/anniversaries, telephoning/visiting family homes, and attending…

Parental Perceptions of Hospital-Based Bereavement Support Following a Child's Death From Cancer: Room for Improvement

CONTEXT: The death of a child from cancer is a devastating event, placing bereaved parents at risk for both physical and psychosocial morbidities. Despite growing awareness of these outcomes and increased hospital-based support, bereaved parents…

Tags: 2021, 2022 Special Edition 2 - Parent Perspectives, Bereavement, Bereavement Support, Child, Childhood Cancer, Dole OR, Grief, Helton G, Hospitals, J Pain Symptom Manage, Morris SE, Neoplasms/therapy, Parents, Perception, Snaman JM, Wolfe J

Parental explicit heuristics in decision-making for children with life-threatening illnesses

OBJECTIVE: To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by…

Parent and clinician preferences for location of end-of-life care: Home, hospital or freestanding hospice?

BACKGROUND: Current options for location of end-of-life (EOL) care for children with cancer include home, hospital, and freestanding pediatric hospice (FSPH). However, access to these options varies greatly depending on geographical location. We…

Palliative care: rapid redesign to support systemwide quality improvement

Large-scale change techniques and rapid redesign methodologies were used to improve the quality of care delivered to patients at the end of life in a large, multihospital healthcare delivery system. By bringing key stakeholders from across the system…

Pain management in the emergency department: patterns of analgesic utilization

OBJECTIVE: To compare the use of analgesia in children to adults in 3 different emergency department (ED) settings. METHODS: Forty adult and 40 pediatric ED charts were randomly selected for review at each of 3 institutions: an academic medical…

Paediatric fever management: continuing education for clinical nurses

PURPOSE: This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. METHOD: Fifty-one nurses from…

Nurse-led paediatric pre operative assessment: an equivalence study

AIM: to explore whether nurses can undertake the pre operative assessment of children prior to day case surgery as safely as senior house officers. DESIGN: a randomised controlled trial involving 595 children, using an equivalence methodology (a…

Neonatal Death In The Emergency Department: When End-of-life Care Is Needed At The Beginning Of Life

The death of a neonate is devastating for all involved. Each year, critically ill neonates present to emergency departments across the United States. These infants require acute medical interventions with a goal of stabilization. Despite these…

Tags: 2016, Clinical Pediatric Emergency Medicine, Emergency Department, Emergency Medical Care, Fetuses, Hospitals, Intensive Care, Jessica T Fry, Mortality, Natalia Henner, Neonatal Bereavement, Neonatal Death, Newborn Babies, November 2016 List, Palliative Care, Stillbirth

Medical care utilization by incurable cancer patients in a Swedish county

A retrospective study of patients with cancer diagnoses treated at a Swedish county hospital was carried out in order to analyse medical care utilization by incurable cancer patients. All 208 patients customarily treated at the Department of General…

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