Novel tool utilized as a trigger for advance care planning in hospitalized oncology patients.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 22-22
Author(s):  
Nicole Lincoln ◽  
Sandhya Rao ◽  
Diane Sarnacki ◽  
Alexandra Dobie ◽  
Karla Damus ◽  
...  
Keyword(s):  
Palliative Care ◽  
Social Services ◽  
Advance Care Planning ◽  
Metastatic Cancer ◽  
Severity Of Illness ◽  
Index Admission ◽  
Cancer Type ◽  
Care Planning ◽  
Oncology Service ◽  
Advance Care

22 Background: Study Purpose: reduce inpatient oncology readmissions; determine if there is a need to standardize trigger for Advance Care Planning in the inpatient oncology population. Methods: Investigational Quality Improvement Study January-June 2014. Retrospective chart review of oncology readmissions on the BMC Hematology and Oncology service during a 6 month period, January-June 2013 (N = 68). Data abstracted included: demographics (age, race/ethnicity, primary language, education, marital status, ECOG); type and stage of cancer; type of consults (palliative, spiritual, social services, integrative, PT/OT, hospice, visiting nurse). Developed a Severity of Illness Scale for use in the oncology inpatient patients at BMC. Results: Mortality rate within 1 year of discharge: 32.8% (non-elective readmissions) 19/58; mean days to death from readmission discharge: 65 days (range 0-252); 84.2% of those who died had metastatic cancer in index admission; only 37% ever had a palliative care consult placed (all on readmit); only 17% had a documented EOL discussion on index admission; 38.5% of patients had lung CA (22% of all non-elective readmissions). Conclusions: (1) There is a need to standardize triggers to goals of care discussions and access to Palliative Care in the Hematology/Oncology Inpatient Population at this Institution. (2) Readmissions may be reduced with better Advance Care Planning. (3) There is a communication gap amongst interdisciplinary teams in regards to Advance Care Planning at this institution. Currently IRB Approval for use of novel severity of illness scale on a maximum 450 patient sample (current N = 300) at daily rounds administered in all inpatients admitted to the Hematology/Oncology Service January 4, 2016-June 30, 2016. Preliminary data shows 25-30% of study sample scoring in for Advance Care Planning with a score of greater than or equal to 4 on novel tool (BMC Cancer Care Severity Of Illness Tool).

Developing a new model of care for patients with cancer who present to the emergency department: The Mayo Clinic experience.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 61-61
Author(s):  
Debra A. Wong ◽  
Tom R. Fitch ◽  
Eric Prommer ◽  
Yu-Hui Chang ◽  
Christopher A. Lipinski
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Supportive Care ◽  
Cancer Patients ◽  
Advance Care Planning ◽  
Emergency Department Visits ◽  
Cancer Type ◽  
Care Planning ◽  
Patients With Cancer ◽  
Advance Care

61 Background: Patients with cancer often have complex symptoms and morbidity that prompt frequent Emergency Department visits. The length of stay in the ED for cancer patients exceeds that of patients without cancer. Patients with cancer are also more likely to be admitted, but are often discharged within 72h. Protracted ED visits, extensive investigations, and the burdens of even a short admission may be distressing and may not be aligned with patients’ care goals and preferences. Furthermore, the healthcare resources dedicated to these patients is considerable and has economic implications. We recently established a Supportive Care Infusion Center (SCIC), an on-campus outpatient unit where patients can receive treatments for symptom relief and comfort; they are assured integrated palliative care with routine oncologic care. We believe there is a subset of cancer patients who can be safely transferred from the ED to the SCIC for appropriate care. Methods: We are retrospectively evaluating cancer patients admitted through the ED to validate clinical parameters likely to lead to admission, and also identify any differences between patients admitted for <72h vs >72h. Patients are analyzed based on symptoms, cancer type, prior cancer therapies, performance status, comorbidities, and presence/absence of advance care planning as well as previous contact with Palliative Care. Data are also being gathered on patient outcomes, including mortality within 60d of admission. Results: Previously established indicators predictive of admission included shortness of breath and SIRS criteria, which our current review validates. We also observe that patients admitted for >72h have greater symptom burden and comorbidities and have received multiple lines of therapy. They also less frequently have advance care planning in place. Data analysis is ongoing. Conclusions: There exists a difference between cancer patients admitted >72h and those discharged within 72h. Awareness of these characteristics may lead to improved workflow in the ED. Identifying patients who may be suitable for transfer to an outpatient supportive care unit rather than short-term admission will also facilitate cost-effectiveness. Future direction includes evaluation of outcomes such as mortality, quality of life, and patient-caregiver satisfaction.

Demenz aus palliativmedizinischer Perspektive: warum ein krankheitsspezifisches Advance Care Planning wichtig ist

2018 ◽  
Vol 75 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Ralf J. Jox ◽  
Francesca Bosisio ◽  
Eve Rubli Truchard
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care ◽  
Menschen Mit Demenz

Zusammenfassung. Die Palliative Care muss sich im Zuge des demographischen Wandels vieler Gesellschaften rund um den Globus tiefgreifend wandeln. Sie muss mehr und mehr mit der Geriatrie zusammenarbeiten und geriatrische Expertise integrieren. Eine der zentralen Herausforderungen Geriatrischer Palliative Care ist die ethisch angemessene Therapieentscheidung für Menschen, die nicht mehr urteilsfähig sind. Nachdem der bisherige Ansatz herkömmlicher Patientenverfügungen erwiesenermassen enttäuscht hat, wird aktuell, gerade auch in deutschsprachigen Ländern, das systemische Konzept des Advance Care Planning (ACP) verfolgt. In diesem Artikel wird zunächst ACP mit seinen Zielen, Elementen und Effekten vorgestellt. Sodann wird gezeigt, weshalb es für Menschen mit Demenz eines adaptierten ACP-Programms bedarf und was ein solches demenzspezifisches ACP beinhalten muss.

Communication around palliative care principles and advance care planning between oncologists, children with advancing cancer and families

2021 ◽  
Author(s):  
Erica C. Kaye ◽  
Cameka Woods ◽  
Kendall Kennedy ◽  
Srilakshmi Velrajan ◽  
Melanie Gattas ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

Welche Relevanz hat Advance Care Planning für die pädiatrische Intensivstation?

intensiv ◽  
2021 ◽  
Vol 29 (02) ◽  
pp. 99-106
Author(s):  
Simone Keller
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

Advance Care Planning hat in der Palliative Care einen hohen Stellenwert. Dabei werden Wünsche und Bedürfnisse von Patienten und deren Familien erfasst, Therapieziele und Maßnahmen für den Krankheitsverlauf und das Lebensende frühzeitig diskutiert und festgehalten. Bei der Betreuung von kritisch kranken Kindern auf der Intensivstation sind Kommunikation und Entscheidungsfindungsprozesse von großer Wichtigkeit, und sie stellen hohe Anforderungen an das Behandlungsteam. Der folgende Beitrag zeigt den Nutzen und die positiven Aspekte von Advance Care Planning, auch für das Setting der Intensivstation.

Predictors of the Willingness to Promote Advance Care Planning among Nurses in Palliative Care Settings in Yogyakarta, Indonesia

2021 ◽  
Vol 11 (3) ◽  
pp. 336-345
Author(s):  
Ike Wuri Winahyu Sari ◽  
Rizqi Wahyu Hidayati
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Pearson Correlation ◽  
Related Factor ◽  
Care Planning ◽  
Cross Sectional ◽  
Correlation Test ◽  
Care Education ◽  
Palliative Care Education ◽  
Advance Care

Background: While previous studies showed that oncology nurses were highly inclined to promote advance care planning (ACP), there is a limited study focusing on ACP that concerns the willingness to promote ACP among palliative nurses in Indonesia. This issue needs to be investigated to determine the causative factors so that interventions for nurses can be arranged to improve ACP in Indonesia.Purpose: This study aimed to identify predictors of the willingness to promote ACP among nurses in palliative care settings.Methods: This study used a descriptive-analytical design with a cross-sectional approach. A total of 150 registered nurses with at least one year of experience were purposively recruited. Data were collected using the Indonesian version of the willingness to promote ACP instrument (I-WPACP) with a possible score range of 24 to 120; the higher the score, the higher the willingness to promote ACP. The descriptive statistic, independent t-test, Pearson correlation test, Spearman rank correlation test, and multiple linear regression test were used to analyze the data.Results: The willingness to promote ACP showed a mean score of 84.73±9.36. The score indicates a high willingness to promote ACP. The experience of receiving palliative care education became a related factor as well as the most closely related factor to the willingness to promote ACP in the palliative care settings (β=0.184; p=0.028).Conclusion: The willingness to promote ACP among nurses is high and closely related to their experience of receiving education about palliative care. Education about palliative care and training on ACP needs to be developed so that nurses can discuss ACP with patients and family caregivers.

scholarly journals Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Maaike Kok ◽  
Gertruud F. M. van der Werff ◽  
Jenske I. Geerling ◽  
Jaap Ruivenkamp ◽  
Wies Groothoff ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Care Needs ◽  
Advance Care ◽  
Palliative Care Needs
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