Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Sep 2015
ReviewImplementing Palliative Care Interdisciplinary Teams: Consultative Versus Integrative Models.
Interdisciplinary teams are at the core of intensive care unit palliative care consultation. They allow health professionals of different disciplines to collaborate in a synergistic fashion to achieve the goals of patients and their families. ⋯ There are multiple benefits to highly functioning teams, as well as challenges that may be faced when trying to provide patient care in a team-based setting. Interdisciplinary teams of different structures may provide the ideal support for complex cases in critical care settings.
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Aggressively managing the symptoms of patients with critical life-limiting illness or terminal disease can improve the quality of life for patients and loved ones, regardless of how much time they have remaining. Palliative symptom management approaches disease in a holistic manner, addressing not only the physical aspect of symptoms but also the psychological, social, and spiritual dimensions of suffering for total symptom relief. Pain is the most common reason for critical care palliative consultation, and using the World Health Organization Pain Ladder to systematically quantify, treat, and titrate pain is effective. Options include both pharmacologic and nonpharmacologic treatment.
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Crit Care Nurs Clin North Am · Sep 2015
ReviewPediatric Palliative Care in the Intensive Care Unit.
The chronicity of illness that afflicts children in Pediatric Palliative Care and the medical technology that has improved their lifespan and quality of life make prognostication extremely difficult. The uncertainty of prognostication and the available medical technologies make both the neonatal intensive care unit and the pediatric intensive care unit locations where many children will receive Pediatric Palliative Care. Health care providers in the neonatal intensive care unit and pediatric intensive care unit should integrate fundamental Pediatric Palliative Care principles into their everyday practice.
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Crit Care Nurs Clin North Am · Sep 2015
ReviewPriorities for Evaluating Palliative Care Outcomes in Intensive Care Units.
Defining the quality of intensive care unit (ICU) care when patients are dying is challenging. Palliative care has been recommended to improve outcomes of dying ICU patients; however, traditional ICU quality indicators do not always align with palliative care. Evidence suggests that some aspects of ICU care improve when palliative care is integrated; however, consensus is lacking concerning the outcomes that should be measured. Overcoming challenges to measuring palliative care will require consensus development and rigorous research on the best way to evaluate ICU palliative care services.