Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study

Background: Medical decision-making has evolved to the modern model of shared decision-making among patients, surrogate decision-makers, and medical providers. As such, informed consent discussions with critically ill patients often should include larger discussions relating to values and goals of care. Documentation of care options and prognosis serves as an important component of electronic communication relating to patient preferences among care providers. Objective: This retrospective chart review study sought to evaluate the prevalence of documentation of critical data, care options, prognosis, and medical plan, within primary team and palliative care consult team documentation. Results: Three hundred two electronic medical records were reviewed. There was a significant difference in documentation between palliative care and primary teams for prognosis (83% vs 32%, P < .001), care options (82% vs 50%, P < .001), and care plan (82% vs 46%, P < .001). Conclusions: Our retrospective chart review study demonstrated a significant difference in documentation between primary and palliative care teams. We acknowledge that review of documentation cannot be extrapolated to the presence or absence of conversations between providers and patients and/or surrogates. Additional studies to evaluate this connection would be advantageous.

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Clinical Use of an Order Protocol for Distress in Pediatric Palliative Care

Healthcare ◽

10.3390/healthcare7010003 ◽

2019 ◽

Vol 7 (1) ◽

pp. 3

Author(s):

Marc-Antoine Marquis ◽

Lysanne Daoust ◽

Edith Villeneuve ◽

Thierry Ducruet ◽

Nago Humbert ◽

...

Keyword(s):

Palliative Care ◽

Respiratory Distress ◽

Chart Review ◽

Retrospective Chart Review ◽

Pediatric Palliative Care ◽

Clinical Use ◽

Borg Scale ◽

Care Experience ◽

Clinical Evolution ◽

Study Support

Several children receiving palliative care experience dyspnea and pain. An order protocol for distress (OPD) is available at Sainte-Justine Hospital, aimed at alleviating respiratory distress, pain and anxiety in pediatric palliative care patients. This study evaluates the clinical use of the OPD at Sainte-Justine Hospital, through a retrospective chart review of all patients for whom the OPD was prescribed between September 2009 and September 2012. Effectiveness of the OPD was assessed using chart documentation of the patient’s symptoms, or the modified Borg scale. Safety of the OPD was evaluated by measuring the time between administration of the first medication and the patient’s death, and clinical evolution of the patient as recorded in the chart. One hundred and four (104) patients were included in the study. The OPD was administered at least once to 78 (75%) patients. A total of 350 episodes of administration occurred, mainly for respiratory distress (89%). Relief was provided in 90% of cases. The interval between administration of the first protocol and death was 17 h; the interval was longer in children with cancer compared to other illnesses (p = 0.02). Data from this study support the effectiveness and safety of using an OPD for children receiving palliative care.

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Retrospective Chart Review Study to Assess Characteristics, Treatment Outcomes and Resource Use of Adults Hospitalized for CAP and CSSTi Treated With Zinforo in Multiple Countries

Case Medical Research ◽

10.31525/ct1-nct04198571 ◽

2019 ◽

Author(s):

Keyword(s):

Treatment Outcomes ◽

Resource Use ◽

Chart Review ◽

Retrospective Chart Review ◽

Review Study

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A Retrospective Chart Review Study to Evaluate Safety of McGhan Single Lumen Gel-Filled Breast Implants in Patients in China

Case Medical Research ◽

10.31525/ct1-nct04261608 ◽

2020 ◽

Author(s):

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Breast Implants ◽

Single Lumen ◽

Review Study

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Harnessing the Chaplain’s Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department

Journal of Palliative Care ◽

10.1177/08258597211003359 ◽

2021 ◽

pp. 082585972110033

Author(s):

Elizabeth Hamill Howard ◽

Rachel Schwartz ◽

Bruce Feldstein ◽

Marita Grudzen ◽

Lori Klein ◽

...

Keyword(s):

Emergency Department ◽

Palliative Care ◽

End Of Life Care ◽

Older Patients ◽

Chart Review ◽

Retrospective Chart Review ◽

Life Care ◽

Emergency Medicine Physician ◽

Medicine Physician ◽

One Year

Objective: To explore chaplains’ ability to identify unmet palliative care (PC) needs in older emergency department (ED) patients. Methods: A palliative chaplain-fellow conducted a retrospective chart review evaluating 580 ED patients, age ≥80 using the Palliative Care and Rapid Emergency Screening (P-CaRES) tool. An emergency medicine physician and chaplain-fellow screened 10% of these charts to provide a clinical assessment. One year post-study, charts were re-examined to identify which patients received PC consultation (PCC) or died, providing an objective metric for comparing predicted needs with services received. Results: Within one year of ED presentation, 31% of the patient sub-sample received PCC; 17% died. Forty percent of deceased patients did not receive PCC. Of this 40%, chaplain screening for P-CaRES eligibility correctly identified 75% of the deceased as needing PCC. Conclusion: Establishing chaplain-led PC screenings as standard practice in the ED setting may improve end-of-life care for older patients.

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Improving patient safety in Palestinian hospitals: a cross-sectional and retrospective chart review study

The Lancet ◽

10.1016/s0140-6736(18)30410-0 ◽

2018 ◽

Vol 391 ◽

pp. S44

Author(s):

Shahenaz Najjar ◽

Nashat Nafouri ◽

Kris Vanhaecht ◽

Martin Euwema

Keyword(s):

Patient Safety ◽

Chart Review ◽

Retrospective Chart Review ◽

Cross Sectional ◽

Review Study

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Tuberous sclerosis complex: Clinical spectrum and epilepsy: A retrospective chart review study

Translational Neuroscience ◽

10.1515/tnsci-2018-0023 ◽

2018 ◽

Vol 9 (1) ◽

pp. 154-160

Author(s):

Sulaiman Almobarak ◽

Mohammad Almuhaizea ◽

Musaad Abukhaled ◽

Suad Alyamani ◽

Omar Dabbagh ◽

...

Keyword(s):

Tuberous Sclerosis ◽

Gene Mutation ◽

Tuberous Sclerosis Complex ◽

Chart Review ◽

Clinical Presentation ◽

Retrospective Chart Review ◽

Neurocutaneous Disorder ◽

Development Delay ◽

Review Study ◽

New Onset

Abstract Tuberous sclerosis complex (TSC) is an autosomal dominant genetic neurocutaneous disorder, with heterogeneous manifestations. We aimed to review the clinical presentation of TSC and its association with epilepsy among Saudi population. This was a retrospective chart review study of 88 patients diagnosed with TSC with or without epilepsy. In 38.6% of patients, symptoms began before 1 year of age. The most frequent initial manifestations of TSC were new onset of seizures (68.2%), skin manifestations (46.6%) and development delay (23.9%). During the evolution of the disease 65.9% had epilepsy, 17% facial angiofibromas, 13.6% Shagreen patch, 18.2% heart rhabdomyomas and 12.5% retinal hamartomas. The genetic study for TSC diagnosis was done for 44 patients, 42 (95,4%) of them were genetically confirmed, for whom 13 patients had TSC1 mutation (29.5%), 29 patients were carrying TSC2 gene mutation (65.9%), Genetic test for TSC 1 and TSC 2 were negative for 2 patients (4.5%) despite positive gene mutation in their relative with TSC. The most common manifestations were central nervous system (predominantly epilepsy) and dermatological manifestations. Most of the patients develop epilepsy with multiple seizure types. TSC 2 mutation is more common than TSC 1 mutation.

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