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Dublin Core
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September 2022 List
Text
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September 2022 List
URL Address
<a href="http://doi.org/10.3389/fped.2022.896232" target="_blank" rel="noreferrer noopener">http://doi.org/10.3389/fped.2022.896232</a>
Dublin Core
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Title
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Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
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Frontiers in Pediatrics
Date
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2022
Subject
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Communication; Ethics; Extracorporeal Membrane Oxygenation; Critical care; ECLS
Creator
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Clark JD; Baden HP; Berkman ER; Bourget E; Brogan TV; Di Gennaro JL; Doorenbos AZ; McMullan DM; Roberts JS; Turnbull JM; Wilfond BS; Lewis-Newby M
Description
An account of the resource
Technological advancements and rapid expansion in the clinical use of extracorporeal life support (ECLS) across all age ranges in the last decade, including during the COVID-19 pandemic, has led to important ethical considerations. As a costly and resource intensive therapy, ECLS is used emergently under high stakes circumstances where there is often prognostic uncertainty and risk for serious complications. To develop a research agenda to further characterize and address these ethical dilemmas, a working group of specialists in ECLS, critical care, cardiothoracic surgery, palliative care, and bioethics convened at a single pediatric academic institution over the course of 18 months. Using an iterative consensus process, research questions were selected based on: (1) frequency, (2) uniqueness to ECLS, (3) urgency, (4) feasibility to study, and (5) potential to improve patient care. Questions were categorized into broad domains of societal decision-making, bedside decision-making, patient and family communication, medical team dynamics, and research design and implementation. A deeper exploration of these ethical dilemmas through formalized research and deliberation may improve equitable access and quality of ECLS-related medical care.
Identifier
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<a href="http://doi.org/10.3389/fped.2022.896232" target="_blank" rel="noreferrer noopener">10.3389/fped.2022.896232</a>
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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).
2022
Baden HP
Berkman ER
Bourget E
Brogan TV
Clark JD
Communication
Critical Care
Di Gennaro JL
Doorenbos AZ
ECLS
Ethics
Extracorporeal Membrane Oxygenation
Frontiers in Pediatrics
Lewis-Newby M
McMullan DM
Roberts JS
September 2022 List
Turnbull JM
Wilfond BS
-
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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May 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
May 2020 List
URL Address
<a href="http://doi.org/10.1089/jpm.2019.0511" target="_blank" rel="noreferrer noopener">http://doi.org/10.1089/jpm.2019.0511</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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Location of Clinician-Family Communication at the End of Life in the Pediatric Intensive Care Unit and Clinician Perception of Communication Quality
Publisher
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Journal of Palliative Medicine
Date
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2020
Subject
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communication; dying and death; end of life; family care conference; palliative care; pediatric critical care; quality
Creator
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Lewis-Newby M; Sellers D E; Meyer E C; Solomon M Z; Zurakowski D; Truog R D
Description
An account of the resource
Background: Communication between clinicians and families of dying children in the pediatric intensive care unit (PICU) is critically important for optimal care of the child and the family. Objective: We examined the current state of clinician perspective on communication with families of dying children in the PICU. Design: Prospective case series over a 15-month study period. Setting/Subjects: We surveyed nurses, psychosocial staff, and physicians who cared for dying children in PICUs at five U.S. academic hospitals. Measurements: Clinicians reported on the location of communication, perceived barriers to end-of-life care, and rated the quality of communication (QOC). Results: We collected 565 surveys from 287 clinicians who cared for 169 dying children. Clinicians reported that the majority of communication occurred at the bedside, and less commonly family conferences and rounds. Ten barriers to care were examined and were reported with frequencies of 2%-32%. QOC was rated higher when the majority of conversations occurred during family conferences (p = 0.01) and lower for patients of non-white race (p = 0.03). QOC decreased when 8 of the 10 barriers to care were reported. Conclusions: When a child is dying, clinicians report that communication with the family occurs most frequently at the child's bedside. This has important implications for future ICU communication research as the majority of previous research and education has focused on family care conferences. In addition, findings that QOC is perceived as lower for non-white patients and when clinicians perceive that barriers hindering care are present can help direct future efforts to improve communication in the PICU.
Identifier
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<a href="http://doi.org/10.1089/jpm.2019.0511" target="_blank" rel="noreferrer noopener">10.1089/jpm.2019.0511</a>
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).
2020
Communication
dying and death
End Of Life
family care conference
Journal of Palliative Medicine
Lewis-Newby M
May 2020 List
Meyer E C
Palliative Care
Pediatric Critical Care
Quality
Sellers D E
Solomon M Z
Truog R D
Zurakowski D