A Child's Last Hours—Multidisciplinary Training in End-of-Life Care for Professionals Working in Children's Hospitals: Newborn With Lethal Congenital Anomalies

MedEdPORTAL ◽  
2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Patricia Keefer ◽  
Ken Pituch ◽  
Terry Murphy ◽  
James Azim ◽  
Cecilia Trudeau ◽  
...  
Keyword(s):  
End Of Life ◽  
Congenital Anomalies ◽  
End Of Life Care ◽  
Life Care ◽  
Children's Hospitals ◽  
Children’S Hospitals

Surgical Interventions During End-of-Life Hospitalizations in Children’s Hospitals

PEDIATRICS ◽  
2021 ◽  
Vol 148 (6) ◽  
Author(s):  
Michael D. Traynor ◽  
Ryan M. Antiel ◽  
Maraya N. Camazine ◽  
Thane A. Blinman ◽  
Michael L. Nance ◽  
...  
Keyword(s):  
End Of Life ◽  
Surgical Procedures ◽  
Asian American ◽  
Race And Ethnicity ◽  
End Of Life Care ◽  
Life Care ◽  
Children's Hospitals ◽  
Patient Age ◽  
Children’S Hospitals ◽  
Patient Âgé

OBJECTIVES To characterize patterns of surgery among pediatric patients during terminal hospitalizations in children’s hospitals. METHODS We reviewed patients ≤20 years of age who died among 4 424 886 hospitalizations from January 2013–December 2019 within 49 US children’s hospitals in the Pediatric Health Information System database. Surgical procedures, identified by International Classification of Diseases procedure codes, were classified by type and purpose. Descriptive statistics characterized procedures, and hypothesis testing determined if undergoing surgery varied by patient age, race and ethnicity, or the presence of chronic complex conditions (CCCs). RESULTS Among 33 693 terminal hospitalizations, the majority (n = 30 440, 90.3%) of children were admitted for nontraumatic causes. Of these children, 15 142 (49.7%) underwent surgery during the hospitalization, with the percentage declining over time (P < .001). When surgical procedures were classified according to likely purpose, the most common were to insert or address hardware or catheters (31%), explore or aid in diagnosis (14%), attempt to rescue patient from mortality (13%), or obtain a biopsy (13%). Specific CCC types were associated with undergoing surgery. Surgery during terminal hospitalization was less likely among Hispanic children (47.8%; P < .001), increasingly less likely as patient age increased, and more so for Black, Asian American, and Hispanic patients compared with white patients (P < .001). CONCLUSIONS Nearly half of children undergo surgery during their terminal hospitalization, and accordingly, pediatric surgical care is an important aspect of end-of-life care in hospital settings. Differences observed across race and ethnicity categories of patients may reflect different preferences for and access to nonhospital-based palliative, hospice, and end-of-life care.

scholarly journals A Child's Last Hours'Multidisciplinary Training in End-of-Life Care in Children's Hospitals: School-Aged Child With Terminal Cancer

MedEdPORTAL ◽  
2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Adam Marks ◽  
Elizabeth Hollenkamp ◽  
Sandra Bradman ◽  
D'Anna Saul ◽  
Matthew Niedner ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Terminal Cancer ◽  
Life Care ◽  
Children's Hospitals ◽  
School Aged Child ◽  
Children’S Hospitals ◽  
Aged Child

A Child's Last Hours'Multidisciplinary Training in End-of-Life Care in Children's Hospitals: Adolescent With Cystic Fibrosis

MedEdPORTAL ◽  
2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Terry Murphy ◽  
D'Anna Saul ◽  
Elizabeth Hollenkamp ◽  
Matthew Niedner ◽  
James Azim ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Children's Hospitals ◽  
Children’S Hospitals

Dysphagia in Hospice Care: The Roles of Social Work and Speech-Language Pathologists

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray
Keyword(s):  
Social Work ◽  
End Of Life ◽  
Case Studies ◽  
End Of Life Care ◽  
Hospice Care ◽  
Patient Communication ◽  
Life Care ◽  
Speech Language Pathologists ◽  
Four Levels

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.

Initiative Improved End-of-Life Care in Homes

2011 ◽  
Vol 12 (6) ◽  
pp. 2
Author(s):  
DAMIAN McNAMARA
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care

End-of-Life Care: Its Cost in Heart Failure

2010 ◽  
Vol 3 (7) ◽  
pp. 6
Author(s):  
SIDNEY GOLDSTEIN
Keyword(s):  
Heart Failure ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care

Die Entwicklung eines Instruments zur «Evaluation stationärer Hospize aus der Perspektive hinterbliebener Angehöriger» (EHPA)

Pflege ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 171-182
Author(s):  
Mandy Lohe ◽  
Manja Zimmermann ◽  
Christiane Luderer ◽  
Katharina Sadowski
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Subjektive Bewertung ◽  
Ethische Probleme

Als Einrichtungen des Gesundheitswesens sind stationäre Hospize in Deutschland zur Qualitätssicherung und internen Qualitätsentwicklung verpflichtet. Die Bedeutung der Patientenzufriedenheit als einer der indirekten Indikatoren zur Beurteilung der Pflege- und Betreuungsqualität ist mittlerweile unumstritten. Eine subjektive Bewertung des Hospizes durch den Gast selbst birgt sowohl praktische als auch ethische Probleme. Eine Befragung der Angehörigen empfiehlt sich. Der vorliegende Artikel beschreibt die Entwicklung eines Instruments zur Evaluation stationärer Hospize aus der Sicht hinterbliebener Angehöriger. Mit dessen Hilfe soll die Frage, wie Angehörige die Begleitung und Pflege beurteilen, die ihnen sowie ihrem verstorbenen Familienmitglied durch das Hospiz zuteil wurde, beantwortet werden. Die Konstruktion der Fragen erfolgte auf Basis bestehender Konzepte zum Assessment der end-of-life care und einer Analyse aller identifizierten Instrumente zur Evaluation stationärer Hospize aus der Perspektive hinterbliebener Angehöriger. Die Fragebogenentwicklung umfasste neben der umfassenden Literaturrecherche die Bildung eines Itempools, die Itemauswahl, die kritische Diskussion der Fragen im Expertenkreis sowie einen standardisierten und kognitiven Pretest. Entstanden ist ein fünfdimensionaler Fragebogen, der physische, psychologische, soziale, spirituelle und versorgungsorganisatorische Aspekte der end-of-life care integriert. Das Instrument umfasst 53 Items in Form überwiegend geschlossener Fragen.

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