43: Emergency Medicine Residents' Knowledge In Key Concepts In Hospice and Palliative Care Before and After an Educational Intervention

Background: There is a growing movement to increase palliative care consults from the emergency department (ED) to reduce healthcare costs and improve quality of life. The surprise question is a screening tool that emergency medicine physicians may be able to use towards achieving this goal. Objective: The objectives of this study were to increase awareness of hospice and palliative care medicine (HPM) among emergency medicine (EM) providers and to evaluate whether this heightened awareness increased palliative care consults among participating emergency medicine providers. Methods: We conducted an anonymous convenience sample survey and two educational interventions about HPM including the surprise question among emergency medicine resident and attending physicians at a large urban public academic quaternary care center from July to November 2018. A report of palliative care consults ordered between August 1, 2017 and January 1, 2019 was generated from the electronic health records used by the hospital. The number of palliative care consults made before and after the educational intervention was compared. Results: After the first educational intervention centered on the surprise question, palliative care consults from the ED increased from an average of 2.25 per month (range 0 to 8, SD: 2.38) to 12.67 per month (range 9 to 19, SD: 4.01, p < .001). Conclusion: Educating EM physicians about the surprise question can increase the number of palliative care consults from the ED, thereby potentially improving patient care and decreasing costs by avoiding unwanted healthcare interventions.

Download Full-text

Final Acts: The End of Life: Hospice and Palliative Care

10.2190/fat ◽

2013 ◽

Keyword(s):

Palliative Care ◽

End Of Life ◽

Hospice And Palliative Care

Download Full-text

Volunteering in hospice and palliative care in the United Kingdom

10.1093/oso/9780198788270.003.0003 ◽

2018 ◽

Author(s):

Ros Scott

Keyword(s):

Palliative Care ◽

United Kingdom ◽

Care Services ◽

The United Kingdom ◽

Strategic Direction ◽

Palliative Care Services ◽

History Of ◽

The Uk ◽

Hospice And Palliative Care ◽

Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

Download Full-text

Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

Palliative & Supportive Care ◽

10.1017/s1478951520001200 ◽

2020 ◽

pp. 1-9

Author(s):

Hyunjin Noh ◽

Lewis H. Lee ◽

Chorong Won

Keyword(s):

Older Adults ◽

Palliative Care ◽

Cognitive Impairment ◽

Educational Intervention ◽

Test Scores ◽

Informal Caregivers ◽

Cognitively Impaired ◽

Significant Difference ◽

Post Test ◽

Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

Download Full-text

Educational intervention for liver transplantation candidates

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692013000100018 ◽

2013 ◽

Vol 21 (1) ◽

pp. 419-425 ◽

Cited By ~ 4

Author(s):

Karina Dal Sasso Mendes ◽

Orlando de Castro e Silva Junior ◽

Luciana da Costa Ziviani ◽

Fabiana Murad Rossin ◽

Márcia Maria Fontão Zago ◽

...

Keyword(s):

Liver Transplantation ◽

Patient Education ◽

Research Design ◽

Educational Intervention ◽

Research Data ◽

Intervention Method ◽

Final Sample ◽

Education Strategy ◽

Before And After ◽

Quasi Experimental

OBJECTIVE: The objective in this study was to analyze candidates' knowledge on the liver transplantation process before and after putting in practice an educational intervention. METHOD: A quasi-experimental, one-group pretest-posttest research design was adopted. The final sample included 15 subjects. Research data were collected between January and March 2010 in three phases, which were: pretest, implementation of the educational intervention (two meetings) and posttest. RESULTS: The results evidenced significant cognitive gains after the intervention, with improvements in the participants' performance . CONCLUSIONS: The research presents evidence that putting in practice a patient education strategy can enhance candidates' knowledge on the liver transplantation process and consequently contribute to a successful treatment.

Download Full-text

Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211030443 ◽

2021 ◽

pp. 104990912110304

Author(s):

Amy Nolen ◽

Rawaa Olwi ◽

Selby Debbie

Keyword(s):

Palliative Care ◽

Acute Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Palliative Sedation ◽

Palliative Care Unit ◽

Care Hospital ◽

Medical Assistance ◽

Medical Assistance In Dying ◽

Before And After

Background: Patients approaching end of life may experience intractable symptoms managed with palliative sedation. The legalization of Medical Assistance in Dying (MAiD) in Canada in 2016 offers a new option for relief of intolerable suffering, and there is limited evidence examining how the use of palliative sedation has evolved with the introduction of MAiD. Objectives: To compare rates of palliative sedation at a tertiary care hospital before and after the legalization of MAiD. Methods: This study is a retrospective chart analysis of all deaths of patients followed by the palliative care consult team in acute care, or admitted to the palliative care unit. We compared the use of palliative sedation during 1-year periods before and after the legalization of MAiD, and screened charts for MAiD requests during the second time period. Results: 4.7% (n = 25) of patients who died in the palliative care unit pre-legalization of MAiD received palliative sedation compared to 14.6% (n = 82) post-MAiD, with no change in acute care. Post-MAiD, 4.1% of deaths were medically-assisted deaths in the palliative care unit (n = 23) and acute care (n = 14). For patients who requested MAiD but instead received palliative sedation, the primary reason was loss of decisional capacity to consent for MAiD. Conclusion: We believe that the mainstream presence of MAiD has resulted in an increased recognition of MAiD and palliative sedation as distinct entities, and rates of palliative sedation increased post-MAiD due to greater awareness about patient choice and increased comfort with end-of-life options.

Download Full-text