Adverse events in hospice and palliative care: a pilot study to determine feasibility of collection and baseline rates

Title

Adverse events in hospice and palliative care: a pilot study to determine feasibility of collection and baseline rates

Creator

Currow DC; Agar MR; To TH; Rowett D; Greene A; Abernethy AP

Publisher

Journal Of Palliative Medicine

Date

2011

Subject

Female; Humans; Male; Young Adult; Adult; Aged; Middle Aged; Pilot Projects; Feasibility Studies; Australia; Urinary Retention; 80 and over; retrospective studies; Palliative Care/standards; Hospice Care/standards; Accidental Falls; Confusion; Hyperglycemia; Hypoglycemia; Hypotension

Description

BACKGROUND: Continuous quality improvement is fundamental in all health care, including hospice and palliative care. Identifying and systematically reducing symptomatic adverse events is limited in hospice and palliative care because these events are mostly attributed to disease progression. OBJECTIVES: The aim of this study was to assess the feasibility of symptomatic adverse events in hospice and palliative care and assessing their incidence. METHODS: A retrospective, consecutive cohort of notes from a specialist palliative care inpatient service was surveyed by a clinical nurse consultant for symptomatic adverse events: falls, confusion, decreased consciousness, hypo- and hyperglycaemia, urinary retention, and hypotension. Demographic and clinical factors were explored for people at higher risk. RESULTS: Data were available on the most recent admissions of 65 people, generating >900 inpatient days. Fifty people (78%) had events precipitating admission, of whom 31 (62%) had at least one further event during admission. Eleven of 15 people who were admitted without an event experienced at least one during their admissions. Only 4 did not have an adverse event. During their stay, there were 0.13 (standard deviation [SD] = 0.19) events per patient per day. No drug-drug or drug-host events were noted. No clinical or demographic factors predicted groups at higher risk. CONCLUSIONS: This pilot highlights the feasibility of collecting, and ubiquity of, symptomatic adverse events, and forms a baseline against which future interventions to decrease the frequency or intensity can be measured. Given the frailty of hospice and palliative patients, any adverse event is likely to accelerate irreversibly their systemic decline.

Rights

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).

Type

Journal Article

Citation List Month

Backlog

Volume

3

Citation

Currow DC; Agar MR; To TH; Rowett D; Greene A; Abernethy AP, “Adverse events in hospice and palliative care: a pilot study to determine feasibility of collection and baseline rates,” Pediatric Palliative Care Library, accessed September 22, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11564.

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