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40
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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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October 2019 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
October 2019 List
URL Address
<a href="http://doi.org/10.1016/j.acap.2019.07.008" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.acap.2019.07.008</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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Pediatric Resident Experience Caring for Children at the End of Life in a Children's Hospital
Publisher
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Academic 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
death; article; child; female; human; major clinical study; male; palliative therapy; retrospective study; controlled study; terminal care; resuscitation; education; medical record review; statistics; burnout; drug withdrawal; Burnout; End-of-Life Care; life sustaining treatment; Palliative Care; postgraduate student; resident; Resident Education
Creator
An entity primarily responsible for making the resource
Trowbridge A; Bamat T; Griffis H; McConathey E; Feudtner C; Walter J K
Description
An account of the resource
OBJECTIVES: Pediatric residents are expected to be competent in end of life (EOL) care. We aimed to quantify pediatric resident exposure to patient deaths, and the context of these exposures. METHOD(S): Retrospective chart review of all deceased patients at one children's hospital over three years collected patient demographics, time and location of death. Mode of death was determined after chart review. Each death was cross-referenced with pediatric resident call schedules to determine residents involved within 48 hours of death. Descriptive statistics are presented. RESULT(S): Of 579 patients who died during the study period, 46% had resident involvement. Most deaths occurred in the NICU (30% of all deaths) however, resident exposure to EOL care most commonly occurred in the PICU (52% of resident exposures) and were after withdrawals of life-sustaining therapy (41%), followed by non-escalation (31%) and failed resuscitation (15%). During their post-graduate year (PGY)-1, <1% of residents encountered a patient death. During PGY-2 and PGY-3, 96% and 78%, respectively, of residents encountered at least one death. During PGY-2, residents encountered a mean of 3.5 patient deaths (range 0-12); during PGY-3, residents encountered a mean of 1.4 deaths (range 0-5). Residents observed for their full 3-year residency encountered a mean of 5.6 deaths (range 2-10). CONCLUSION(S): Pediatric residents have limited but variable exposure to EOL care, with most exposures in the ICU after withdrawal of life-sustaining technology. Educators should consider how to optimize EOL education with limited clinical exposure, and design resident support and education with these variable exposures in mind. Copyright © 2019. Published by Elsevier Inc.
Identifier
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<a href="http://doi.org/10.1016/j.acap.2019.07.008" target="_blank" rel="noreferrer noopener">10.1016/j.acap.2019.07.008</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).
2019
Academic pediatrics.
Article
Bamat T
Burnout
Child
Controlled Study
Death
Drug Withdrawal
Education
End-of-life Care
Female
Feudtner C
Griffis H
Human
Life Sustaining Treatment
Major Clinical Study
Male
McConathey E
Medical Record Review
October 2019 List
Palliative Care
Palliative Therapy
postgraduate student
Resident
resident education
Resuscitation
Retrospective Study
Statistics
Terminal Care
Trowbridge A
Walter J K
-
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
December 2018 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
December 2018 List
URL Address
<a href="http://doi.org/10.1542/peds.2017-4182" target="_blank" rel="noreferrer noopener"> http://doi.o
rg/10.1542/peds.2017-4182</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
Modes of Death Within a Children's Hospital
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
2018
Subject
The topic of the resource
Human; Length of Stay; Child; Hospitalization; Intensive Care Units Pediatric; Treatment Failure; Referral and Consultation; Palliative Care; Hospitals Pediatric; Intensive Care Units Neonatal; Resuscitation; Confidence Intervals; Odds Ratio; Qualitative Studies; Descriptive Statistics; Race Factors; Retrospective Design; Whites; Blacks; Hospital Mortality -- In Infancy and Childhood; Multiple Logistic Regression
Creator
An entity primarily responsible for making the resource
Trowbridge A; Walter JK; McConathey E; Morrison W; Feudtner C
Description
An account of the resource
BACKGROUND: Knowledge about how children die in pediatric hospitals is limited, and this hinders improvement in hospital-based end-of-life care. METHODS: We conducted a retrospective chart review of all the patients who died in a children's hospital between July 2011 and June 2014, collecting demographic and diagnostic information, hospital length of stay, location of death, and palliative care consultation. A qualitative review of provider notes and resuscitation records was used to create 5 mutually exclusive modes of death, which were then assigned to each patient. Analysis included the calculation of descriptive statistics and multinomial logistic regression modeling. RESULTS: We identified 579 patients who were deceased; 61% were <1 year of age. The ICU was the most common location of death (NICU 29.7%; PICU 27.8%; cardiac ICU 16.6%). Among the 5 modes of death, the most common was the withdrawal of life-sustaining technology (40.2%), followed by nonescalation (25.6%), failed resuscitation (22.8%), code then withdrawal (6.0%), and death by neurologic criteria (5.3%). After adjustment, patients who received a palliative care consultation were less likely to experience a code death (odds ratio 0.31; 95% confidence interval 0.13--0.75), although African American patients were more likely than white patients to experience a code death (odds ratio 2.46; 95% confidence interval 1.05--5.73), mostly because of code events occurring in the first 24 hours of hospitalization. CONCLUSIONS: Most deaths in a children's hospital occur in ICUs after the withdrawal of life-sustaining technology. Race and palliative care involvement may influence the manner of a child's death.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2017-4182" target="_blank" rel="noreferrer noopener">10.1542/peds.2017-4182</a>
2018
Blacks
Child
Confidence Intervals
December 2018 List
Descriptive Statistics
Feudtner C
Hospital Mortality -- In Infancy and Childhood
Hospitalization
Hospitals Pediatric
Human
Intensive Care Units Neonatal
Intensive Care Units Pediatric
Length Of Stay
McConathey E
Morrison W
Multiple Logistic Regression
Odds Ratio
Palliative Care
Pediatrics
Qualitative Studies
Race Factors
Referral And Consultation
Resuscitation
Retrospective Design
Treatment Failure
Trowbridge A
Walter JK
Whites