Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review

2017 ◽  
Vol 32 (1) ◽  
pp. 299-307 ◽  
Author(s):  
Marco Artico ◽  
Angelo Dante ◽  
Daniela D’Angelo ◽  
Luciano Lamarca ◽  
Chiara Mastroianni ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Palliative Care ◽  
Pressure Ulcer ◽  
Associated Factors ◽  
Chart Review ◽  
Pressure Ulcers ◽  
Terminally Ill ◽  
Retrospective Chart Review ◽  
Karnofsky Performance Scale ◽  
Performance Scale

Background: Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers’ prevalence, incidence and associated factors are largely insufficient. Aim: To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients’ and caregivers’ characteristics associated with their occurrence. Design: Retrospective chart review. Setting/participants: Patients ( n = 574) with a life expectancy ⩽6 months admitted to a palliative home care service were included in this study. Results: The prevalence and incidence rates were 13.1% and 13.0%, respectively. The logistic regression models showed body mass index ( p < 0.001), Braden score at risk ( p < 0.001), Karnofsky Performance Scale index <30 ( p < 0.001), patients’ female gender, patients’ age >70 and >1 caregiver at home as the dichotomous variables predictors of presenting with a pressure ulcer at time of admission and during home palliative care. Conclusion: The notable pressure ulcers’ incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses’ clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers’ characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient’s needs.

scholarly journals Benzodiazepine Use and Morbidity-Mortality Outcomes in a Geriatric Palliative Care Unit: A Retrospective Review

2021 ◽  
pp. 1-9
Author(s):  
Helen Senderovich ◽  
Sandra Gardner ◽  
Anna Berall ◽  
Michael Ganion ◽  
Dennis Zhang ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Scale Score ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Increased Risk ◽  
Benzodiazepine Use ◽  
Hospice And Palliative Care ◽  
Performance Scale ◽  
Overall Mortality

<b><i>Introduction:</i></b> Patients often experience delirium at the end of life. Benzodiazepine use may be associated with an increased risk of developing delirium. Alternate medications used in conjunction with benzodiazepines may serve as an independent precipitant of delirium. The aim is to understand the role of benzodiazepines in precipitating delirium and advanced mortality in palliative care population at the end of life. <b><i>Methods:</i></b> A retrospective medical chart review was conducted at a hospice and palliative care inpatient unit between the periods of June 2017–December 2017 and October 2017–November 2018. It included patients in hospice and palliative care inpatient units who received a benzodiazepine and those who did not. Patient characteristics, as well as Palliative Performance Scale score, diagnosis, and occurrence of admission, terminal, and/or recurrent delirium, were collected and analyzed. <b><i>Results:</i></b> Use of a benzodiazepine was not significantly associated with overall mortality nor cause-specific death without terminal delirium rate. However, it was significantly associated with higher cause-specific death with terminal delirium rate and a higher recurrent delirium rate. <b><i>Discussion:</i></b> This retrospective chart review suggests an association between benzodiazepine use and specific states of delirium and cause-specific death. However, it does not provide strong evidence on the use of this drug, especially at the end of life, as it pertains to the overall mortality rate. Suggested is a contextual approach to the use of benzodiazepines and the need to consider Palliative Performance Scale score and goals of care in the administration of this drug at varying periods during patient length of stay.

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

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.

A real-world comparison of efficacy and toxicity of FOLFIRINOX and gemcitabine to nab-paclitaxel in treatment of advanced stage pancreatic cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16728-e16728
Author(s):  
Shaik Abdul Samad Shaik Abdul Rashid ◽  
Steven Cohen ◽  
Ida Micaily
Keyword(s):  
Selection Criteria ◽  
Chart Review ◽  
Median Overall Survival ◽  
Chemotherapy Regimen ◽  
Metastatic Cancer ◽  
Performance Status ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
The United States ◽  
Performance Scale

e16728 Background: Pancreatic adenocarcinoma is a dreaded malignancy accounting for 7% of all cancer related deaths in the United States. The two most used chemotherapeutic regimens are a combination of 5- fluorouracil, leucovorin, oxaliplatin and irinotecan (FFX) and a combination of gemcitabine nab paclitaxel (GN). Both improve survival when compared to gemcitabine alone but have not been compared directly. Methods: Retrospective chart review of 83 chemotherapy naïve patients with metastatic cancer of exocrine pancreas who underwent chemotherapy between February 2011 and June 2017. Patients who completed at least one cycle of chemotherapy regimen were included. Characteristics, efficacy and adverse events between the two regimens were compared using appropriate statistical analyses. Results: 83 patients met selection criteria. 39 patients received FFX and 44 received GN. Mean age of FFX and GN patients was 69.7 (SD 8.7) (Median 66) and 72.3 (SD 8.8) (Median 69) yrs respectively (p = 0.100). The proportion of patients with ECOG performance scale ≤1 receiving FFX vs. GN was 50.8% vs. 49.2% and > 2 receiving FFX vs. GN was 33.3% vs 66.7% (p = .286). Of the 23 patients > 75 yrs., 7 received FFX and 16 received GN (p = .086). Median overall survival was 10.1 months (95% CI: 5.4-18.7) in FFX and 7.2 months in GN (95% CI: 5.4-11.3) [p = 0.037]. Median survival based on site of tumor was 10.2 months (95% CI: 6.7-13.8) in head and 10.1 months (95% CI: 4.3-14.7) in body and tail tumors [p = 0.776]. Incidence of vomiting in FFX / GN was 94.1% / 73.7% (p =.027), vomiting requiring hospital admission was 55.9% / 21.1% (p = 0.003). Other events requiring admission included: diarrhea 31.4% / 17.9%; anemia 5.7% / 10.3%; thrombocytopenia 11.4% / 7.7%; febrile neutropenia 28.6% / 12.8% and acute kidney injury 25.7% / 15.4%; no statistically significant differences between groups. Conclusions: Patients treated with FFX had a longer survival in this retrospective review. FFX is associated with an increased incidence of vomiting requiring hospitalization. FFX remains a preferred regimen in treating patients with good performance status regardless of age.

scholarly journals Identification of patients with noncancer diseases for palliative care services

2005 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
CAROL GRBICH ◽  
IAN MADDOCKS ◽  
DEBORAH PARKER ◽  
MARGARET BROWN ◽  
EILEEN WILLIS ◽  
...  
Keyword(s):  
Palliative Care ◽  
Aged Care ◽  
Residential Aged Care ◽  
Karnofsky Performance Scale ◽  
Care Services ◽  
Aged Care Facilities ◽  
Palliative Care Services ◽  
Residential Aged Care Facilities ◽  
End Stage ◽  
Performance Scale

Objective: To identify criteria for measuring the eligibility of patients with end-stage noncancer diseases for palliative care services in Australian residential aged care facilities.Methods: No validated set if guidelines were available so five instruments were used: an adaptation of the American National Hospice Association Guidelines; a recent adaptation of the Karnofsky Performance Scale; the Modified Barthel Index; the Abbey Pain Score for assessment of people who are nonverbal and a Verbal Descriptor Scale, also for pain measurement. In addition, nutritional status and the presence of other problematic symptoms and their severity were also sought.Results: The adapted American National Hospice Association Guidelines provided an initial indicative framework and the other instruments were useful in providing confirmatory data for service eligibility and delivery.

scholarly journals Perspectivas para os cuidados paliativos na atenção primária à saúde: estudo descritivo

2016 ◽  
Vol 15 (4) ◽  
pp. 683
Author(s):  
Cissa Azevedo ◽  
Camila Maria Pereira Rates ◽  
Juliana Dias Reis Pessalacia ◽  
Luciana Regina Ferreira Da Mata
Keyword(s):  
Palliative Care ◽  
Cardiovascular Diseases ◽  
Primary Healthcare ◽  
Medical Records ◽  
Professional Training ◽  
Health Sector ◽  
The Elderly ◽  
Karnofsky Performance Scale ◽  
Early Care ◽  
Performance Scale

Aim: To identify eligible patients for palliative care and characterize the  services  involved  in  primary  healthcare.  Method:  This  was  a  descriptive  and documental  study  conducted  in  19  health  units  in  a  municipality  in  the  countryside  of Minas  Gerais  in  Brazil.  The  Karnofsky  performance  scale  was  applied  to  the  medical records  of  patients  in  the  health  sector  with  the  largest  number  of  eligible  individuals. Results:  We  identified  2,715  eligible  individuals,  representing 3.59%  of  the  registered population  and  25.3%  of  patients  in  sector  seven,  which  had the  highest  number  of eligible  individuals.  Diabetes  was the most common  pathology,  followed  by  cancer  and cardiovascular   diseases.   Furthermore,   17.2%   of   these   individuals   have   required palliative  care  precociously;  9.7%,  required  exclusive  care,  and  the  elderly  above  60 years  constituted  the  highest  number  among  those  eligible.  Discussion:  The  data confirmed  the  need  for  structuring  the  primary  healthcare  for  early  care in  palliative care,  especially  for  the  elderly.  Conclusion:  It is  necessary to  structure  a  care  network that is integrated and ordained by PHC and professional training.

scholarly journals Nurses’ knowledge of pressure ulcer and its associated factors at Hawassa University Comprehensive Specialized Hospital Hawassa, Ethiopia, 2018.

2020 ◽  
Author(s):  
Ezedin Molla Muhammed ◽  
Berhanu Boru Bifftu ◽  
Yemataw Zewdu Temachu ◽  
Tarkie Abebe Walle
Keyword(s):  
Pressure Ulcer ◽  
Associated Factors ◽  
Pressure Ulcers ◽  
Sampling Technique ◽  
Signs And Symptoms ◽  
Knowledge Score ◽  
Simple Random Sampling ◽  
Cross Sectional ◽  
The Mean ◽  
Nurses Knowledge

Abstract Background: Pressure ulcer is largely avoidable, but its prevalence rate increased more than 80% in a thirteen years study. Nurses have a great position to advance best practices towards the prevention of pressure ulcers. Therefore they should be knowledgeable of the signs and symptoms of pressure ulcers, and preventive strategies to reduce its incidence, but there is limited evidence on nurses’ knowledge and its associated factors to prevent pressure ulcer in Ethiopia. Methods: A hospital-based cross-sectional study was conducted from March 25 – April 23/ 2018. A total of 356 nurses were selected by stratification with a simple random sampling technique. Pretested structured questionnaire with closed and open-ended questions was used to collect data. Frequency distribution and percentage were computed to describe each variable. Bivariate and multivariable logistic regression with a 95% confidence interval was also carried out to see the effect of each independent variable on the dependent variable and declared statistical significant association with P< 0.05. Result: The mean knowledge score of nurses was 25.22 out of 41 item questions. Fifty-two point five percent of nurses score above the mean. Males [AOR=0.44, 95% CI (0.26 – 0.73)], working a maximum of eight hours [AOR= 3.57, 95% CI (1.48 – 8.61), not having training [(AOR= 2.31, 95% CI (1.14 – 4.61)], Low salary [AOR= 3.47, 95% CI (1.03 – 11.67)] were significantly associated with inadequate knowledge. Conclusion: Generally a nurse's knowledge of pressure ulcer was inadequate. Being female, working less than or equal to eight hours, not having the training and low working salary are contributors to a low level of knowledge for pressure ulcer.

scholarly journals Nurses’ knowledge of pressure ulcer and its associated factors at Hawassa University Comprehensive Specialized Hospital Hawassa, Ethiopia, 2018.

2019 ◽  
Author(s):  
Tarkie Abebe Walle ◽  
Ezedin Molla Muhammed ◽  
Berhanu Boru Bifftu ◽  
Yemataw Zewdu Temachu
Keyword(s):  
Pressure Ulcer ◽  
Associated Factors ◽  
Pressure Ulcers ◽  
Sampling Technique ◽  
Signs And Symptoms ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
The Mean ◽  
Hawassa University ◽  
Nurses Knowledge

Abstract Introduction Pressure ulcer is largely avoidable, but its prevalence rate increased more than 80% in a thirteen years study. Nurses have a great position to advance best practices towards the prevention of pressure ulcers. Therefore they should be knowledgeable of the signs and symptoms of pressure ulcers, and preventive strategies to reduce its incidence, but there is limited evidence on nurses’ knowledge and its associated factors to prevent pressure ulcer in Ethiopia.Objectives The study aimed to assess nurses' knowledge and associated factors towards pressure ulcer prevention at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia, 2018.Methods A hospital-based cross-sectional study was conducted from March 25 – April 23/ 2018. A total of 356 nurses were selected by stratification with a simple random sampling technique. Pretested structured questionnaire with closed and open-ended questions was used to collect data. Frequency distribution and percentage were computed to describe each variable. Bivariate and multivariable logistic regression with a 95% confidence interval was also carried out to see the effect of each independent variable on the dependent variable and declared statistical significant association with P< 0.05.Result The mean knowledge score of nurses was 25.22 out of 41 item questions. Fifty-two point five percent of nurses score above the mean. Males [AOR=0.44, 95% CI (0.26 – 0.73)], working a maximum of eight hours [AOR= 3.57, 95% CI (1.48 – 8.61), not having training [(AOR= 2.31, 95% CI (1.14 – 4.61)], Low salary [AOR= 3.47, 95% CI (1.03 – 11.67)] were significantly associated with inadequate knowledge.Conclusion Generally a nurse's knowledge of pressure ulcer was inadequate. Being female, working less than or equal to eight hours, not having the training and low working salary are contributors to a low level of knowledge for pressure ulcer.

scholarly journals Drug poisoning and associated factors in Western Saudi Arabia: A five-year retrospective chart review (2011–2016)

2017 ◽  
Vol 33 (5) ◽  
Author(s):  
Sami Hamdan Alzahrani ◽  
Ali H. Alqahtani ◽  
Fayssal Mostafa Farahat ◽  
Mohammed Abdel Galil Elnour ◽  
Jamil Bashawri
Keyword(s):  
Saudi Arabia ◽  
Associated Factors ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Drug Poisoning
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