Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Download or read book Improving End of life Care in the Intensive Care Unit written by Mercy Joseph and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The end of life care has rising focus nowadays associated with increasing life expectancy and advanced technologies to prolong life. Advance care planning and initiation of palliative care services bring hope to the patient population to enhance the quality of life at their end stages of life. According to the study shows, there are 22% of death happens in the intensive care unit in the United States (Troug et al, 2008), so the pursuit of quality care has increased interest in the designated area. Based on the research studies, the advance care planning and the comfort care services enhance quality of life, decreased use of life sustaining treatments, decreased hospital length of stay, increased use of hospice or palliative care services, and better patient/family cope up and satisfaction. The main objective of the study is to enhance the quality of life among patients with terminal and chronic life limiting illness by implementing a strategic plan of end of life care. The implementation plan includes the use of Physician orders for life sustaining treatment form (POLST) for all ICU patients, family conferences, routine palliative care consultation, and an added educational training of the health care workers, can provide a holistic care to the dying patients. The comfort theory will be incorporated into the project by assessing the patient needs, nursing interventions, and the evaluation of patient comfort. An end of life care survey has developed to evaluate the family and staff satisfaction with the above implementation plan. A dissemination of the project outcome will be communicated to the stakeholders through open meetings/discussions, staff development program, and make use of the organizational website and newsletters.

Download or read book End of Life Care in the ICU written by Graeme Rocker and published by Oxford University Press, USA. This book was released on 2010-01-28 with total page 403 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book highlights real clinical issues which need to be addressed if quality palliative care within ICUs is to be consistently delivered. It is presented in an easily accessible, bullet pointed style, and is illustrated with case histories from real-life patients, and drug tables.

Download or read book Palliative Care in Cardiac Intensive Care Units written by Massimo Romanò and published by Springer Nature. This book was released on 2021-09-29 with total page 195 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book analyzes the main topics of Palliative Care in Cardiac Intensive Care Units (CICU), from the changing epidemiology of patients admitted to the ICU, to the main clinical and ethical issues. The changing epidemiology of patients has led to new and emerging patient needs at the end of life. Care has shifted from acute coronary syndrome patients towards elderly patients, with a high prevalence of non-ischemic cardiovascular diseases and a high burden of non-cardiovascular comorbid conditions: both increase the susceptibility of patients to developing life-threatening critical conditions. These conditions are associated with a significant symptom burden, high mortality rate, and increased length of stay. The main new challenges involve shared decision-making, symptom control (pain, dyspnea, etc.), and ethical issues (withholding/withdrawing life sustaining treatments, deactivation of implanted cardiac devices, palliative sedation), all of which necessitate formal education on end-of-life care. Written by opinion leaders in their respective fields, who share their experience with improving the cultural and clinical competence of medical/nursing teams, this volume is chiefly intended for cardiologists, anesthesiologists, palliative care doctors and nursing staff.

Download or read book Improving End of life Care in the Intensive Care Unit Through Education and Palliative Care Consultations written by Jennifer Irvine and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Difficulties persist with end-of-life (EOL) decision making in intensive care units (ICUs), leading to stress for surrogates and treatment that may not reflect patient values. The objective of this proposal is to educate nurses on EOL care and decision making so they may be better prepared to care for dying patients and assist surrogates in EOL decision making. This proposal also aims to increase the presence of palliative care (PC) in these cases, in an effort to improve the quality of care for patients suffering from advanced disease. Research has shown that clinicians feel inadequately trained in EOL care (Balistrieri, Montagnini, and Smith, 2012). Also, PC consultations have been shown to help reduce ICU length of stay and improve patient and family satisfaction of EOL care (Buckley and others, 2007). Based on a literature review of over 15 research based studies, a proposal has been established that includes providing nurses with a two hour training session regarding EOL care, with an emphasis on communication, PC, and surrogate decision making. Also proposed, is implementation of a PC screening tool that will help identify patients that are suitable for a PC consultation. The proposal will potentially help improve EOL care and transitions in the ICU. Implementation will take place over a two month time period with all ICU nurses receiving a two hour session of advanced EOL and PC training. All ICU physicians and nurses will be oriented to the PC screening tool. Following six months of implementation, the plan will be evaluated for feasibility, perceived effectiveness, and acceptability through staff interviews, questionnaires, and evaluation of the difference in patient stay compared to prior to implementation of the proposal. Results of the evaluation will be disseminated to clinical nurses and physicians through posters and handouts.

Download or read book Managing Death in the ICU written by J. Randall Curtis and published by Oxford University Press. This book was released on 2001 with total page 407 pages. Available in PDF, EPUB and Kindle. Book excerpt: A clear and concise statement of facts and causes that have led step by step to the present deplorable condition of public affairs and the corruption of the body politic"--Preface.

Download or read book Approaching Death written by Committee on Care at the End of Life and published by National Academies Press. This book was released on 1997-10-30 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Download or read book Improving End of Life Care written by Ashley Lawrence and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The number of people dying in the Intensive Care Units (ICU) of Hospitals is growing each year. "At least 1 in 5 Americans die while using intensive care service and–a number that is expected to increase as society ages" (Espinosa, Young, Symes, Haile, and Walsh, 2010, pages273). Nurses in the ICU are now required to not only provide life-sustaining care but also be competent in the complexities of end-of-life (EOL) care including withdrawing life support, symptom management, and emotional support for that patient and their loved ones. However, in spite of these statistics critical care nurses perceptions of providing EOL care in the ICU are not without concern. Research shows that critical care nurses feel that the number one barrier in providing EOL care is lack of knowledge (Beckstrand and Kirchhoff, 2005). Nurses also hold self-perceived deficiencies in EOL care competencies and require unique educational needs (Montagnini, Smith, and Balistrieri, 2012). The presented capstone project describes a pilot program that includes the implementation of EOL care education and standardized policy, procedure, and order sets in the ICU. The proposed education is tailored to critical care nurses and uses the Endof- Life Care Nursing Education Consortium train the trainer curriculum. The aim of the program is improve the quality of care at EOL in the ICU through education and the development of policy, procedure, and stander order sets.

Download or read book Geriatric Emergency Medicine written by Joseph H. Kahn and published by Cambridge University Press. This book was released on 2014-01-16 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.

Download or read book Managing End of life Care in the Intensive Care Unit written by Dr. Gilly Smith and published by . This book was released on 2009 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Choices in Palliative Care written by Arthur Blank and published by Springer Science & Business Media. This book was released on 2007-07-21 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: Choices in Palliative Care brings together leading experts to spotlight core issues in the field and identify ways PC can fill gaps in current care systems. This far-sighted volume redefines palliative care as interdisciplinary and integrative, bridging acute and long-term care to respond to clients’ evolving needs. Those teaching health service delivery courses will find this material especially useful.

Download or read book Extreme Measures written by Dr. Jessica Nutik Zitter, M.D. and published by Penguin. This book was released on 2021-08-24 with total page 353 pages. Available in PDF, EPUB and Kindle. Book excerpt: For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.

Download or read book Textbook of Palliative Care written by Roderick Duncan MacLeod and published by Springer. This book was released on 2025-05-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This second edition provides the most up-to-date information on all aspects of palliative care including recent developments (including COVID-19), global policies, service provision, symptom management, professional aspects, organization of services, palliative care for specific populations, palliative care emergencies, ethical issues in palliative care, research in palliative care, public health approaches and financial aspects of care. This new Textbook of Palliative Care remains a unique, comprehensive, clinically relevant and state-of-the art book, aimed at advancing palliative care as a science, a clinical practice and as an art. Palliative care has been part of healthcare for over fifty years but we still needs to be explained. Healthcare education and training has been slow to recognize the vital importance of ensuring that all practitioners have a good understanding of what is involved in the care of people with serious or advanced illnesses and theirfamilies. However, the science of palliative care is advancing and this new edition will contribute to a better understanding of this specialty. This new edition offers 20 new chapters out of over 120, written by experts in their given fields provide up-to-date information on a wide range of topics of relevance to those providing care towards the end of life no matter what the disease may be. We present a global perspective on contemporary and classic issues in palliative care with authors from a wide range of disciplines involved in this essential aspect of care. The Textbook includes sections addressing aspects such as symptom management and care provision, organization of care in different settings, care in specific disease groups, palliative care emergencies, ethics, public health approaches and research in palliative care. This new Textbook will be of value to practitioners in all disciplines and professions where the care of people approaching death is important, specialists as well as non-specialists, in any setting where people with serious advanced illnesses are residing. It is also an important resource for researchers, policy-and decision-makers at national or regional levels. Neither the science nor the art of palliative care will stand still so the Editors and contributors from all over the world aim to keep this Textbook updated so that the reader can find new evidence and approaches to care.

Download or read book Palliative Care in Critical Care An Issue of Critical Care Nursing Clinics of North America written by Tonja Hartjes and published by Elsevier Health Sciences. This book was released on 2016-07-22 with total page 137 pages. Available in PDF, EPUB and Kindle. Book excerpt: Intensive care units (ICUs) provide comprehensive, advanced care to patients with serious or life-threatening conditions and consequently, a significant amount of end-of-life care (EOLC). Indeed, approximately 20% of deaths in the U.S. are associated with an ICU stay, and nearly half of U.S. patients who die in hospitals experience an ICU stay during the last 3 days of life. Despite the commonality of the ICU experience, ICU patients typically suffer from a range of distressing symptoms such as pain, fatigue, anxiety, and dyspnea, causing families significant distress on their behalf. Thus, there is a growing imperative for better provision of palliative care (PC) in the ICU, which may prevent and relieve suffering for patients with life threatening illnesses. Effective palliative care is accomplished through aggressive symptom management, communication about the patient and family’s physical, psychosocial and spiritual concerns, and aligning treatments with each patient’s goals, values, and preferences. PC is also patient-centered and uses a multidisciplinary, team-based approach that can be provided in conjunction with other life-sustaining treatments, or as a primary treatment approach. Failure to align treatment goals with individual and family preferences can create distress for patients, families, and providers. If implemented appropriately, palliative care may significantly reduce the health care costs associated with intensive hospital care, and help patients avoid the common, non-person centered treatment that is wasteful, distressing, and potentially harmful. Due to the success of many PC programs, administrators, providers, and accrediting bodies are beginning to understand that palliative care in the ICU is vital to optimal patient outcomes.

Download or read book Palliative Care in Oncology written by Bernd Alt-Epping and published by Springer. This book was released on 2015-03-26 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: Palliative care provides comprehensive support for severely affected patients with any life-limiting or life-threatening diagnosis. To do this effectively, it requires a disease-specific approach as the patients’ needs and clinical context will vary depending on the underlying diagnosis. Experts in the field of palliative care and oncology describe in detail the needs of patients with advanced cancer in comparison to those with non-cancer disease and also identify the requirements of patients with different cancer entities. Basic principles of symptom control are explained, with careful attention to therapy for pain associated with either the cancer or its treatment and to symptom-guided antineoplastic therapy. Complex therapeutic strategies for palliative cancer patients are highlighted that involve both cancer- and symptom-directed options and address a range of therapeutic aims. Issues relating to drug use in palliative cancer care are fully explored, and a separate section is devoted to care in the final phase. A range of organizational and policy issues are also discussed, and the book concludes by considering likely future developments in palliative care for cancer patients. Palliative Care in Oncology will be of particular interest to palliative care physicians who are interested in broadening the scope of their disease-specific knowledge, as well as to oncologists who wish to learn more about modern palliative care concepts relevant to their day-to-day work with cancer patients.

Download or read book Developing an Educational Pamphlet to Improve Adult Intensive Care Unit Nurses Care Delivery at End of Life written by Dean L. Bates and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: While much research has been conducted on the quality of End of Life (EoL) care, little has changed in how healthcare providers (especially nurses) are educated on this topic. Current literature demonstrates a lack of education that can be broken down into two themes: effective communication and knowledge regarding optimum EoL care. A pamphlet was created for Intensive Care Unit (ICU) nurses on improving EoL care for dying patients, families and social networks. The researcher’s clinical experience was combined with EoL experts’ knowledge. These experts are providers from hospice care, palliative care, social work, ICU’s, and spiritual care. Suggestions from these experts provided a basis for modifications to a pamphlet created by the researcher. In future, this pamphlet may be utilized by ICU nurses who want support and guidance when taking care of patients, families, and social networks at the end of life.

Download or read book Improving Critical Care Survivorship written by Kimberley J. Haines and published by Springer Nature. This book was released on 2021-04-22 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive overview of improving critical care survivorship. Comprised of four sections, the text presents interventions that can be used to improve patient outcomes and reduce the burden of post-intensive care syndrome across the arc of care, from the ICU to returning home. The first section of the text focuses on preventing adverse outcomes in the ICU, with an emphasis on implementing early mobilization, engaging and supporting families, and employing various forms of therapy. The second section revolves around enhancing recovery post-ICU, focusing on physical and neurocognitive rehabilitation programs, peer support, and poly-pharmacy management. Community reintegration is the subject of the third section, with emphasis on socioeconomic reintegration, healthcare utilization, and volunteerism in ICU recovery. The book concludes with a section on future considerations, specifically spotlighting preliminary ideas that address long-term sequelae and international collaboration to solve critical care challenges. Written by experts in the field, Improving Critical Care Survivorship: A Guide for Prevention, Recovery, and Reintegration is a valuable resource for critical care clinicians and researchers interested in improving the quality of patient survival after ICU admission.