Journal of palliative medicine
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To add to the data regarding the quality of care given to dying children and their families. ⋯ Relationship exists between diagnosis, cause and place of death in this population; findings replicate findings of 4 similar studies; accurate and consistent quality standards of care need to be established for this population as well as methods of documentation before reviewing/accrediting agencies impose standards that are not evidence based.
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Ketamine is an effective analgesic agent for treating a variety of neuropathic and cancer pain syndromes. Recent studies indicate that ketamine may have a particular role in the management of patients with neuropathic and/or pain syndromes that are poorly responsive to opioids. ⋯ The audit confirmed the safety and effectiveness of ketamine as an analgesic adjuvant for patients with severe pain. Baseline opioid dose reduction and prophylactic use of haloperidol or benzodiazepine were effective in minimizing psychotomimetic side effects.
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The ability of families to assume caregiving responsibilities is contingent on material, social, and professional support. Inadequate or inappropriate support to the terminally ill and their family caregivers can result in the misuse of resources and add burden to the family. In this report, we describe service preferences among informal caregivers of the terminally ill. ⋯ The findings reported in this paper provide important insights into caregiver perceptions of valued services when caring for a terminally ill family member. These finding also highlight the stability of caregiver service perceptions over time and into bereavement.
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Previous research has demonstrated that nursing education has not prepared nurses to provide optimum end-of-life (EOL) care; and yet, care of patients at the EOL is contingent on adequate preparation of nurses. To date, there has not been a unified or organized effort to broadly address the preparation of nurses in EOL care. ⋯ This national organized effort is a major step toward preparing nurses in EOL care to improve care of the dying.
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Comparative Study
Impact of palliative care case management on resource use by patients dying of cancer at a Veterans Affairs medical center.
The VA Puget Sound Health Care System (VAPSHCS) started a palliative care service (PCS) in October 2001 to provide case management for patients with advanced cancer. ⋯ PCS for 60 or more days prior to death was associated with decreased use of acute care hospital resources for patients dying of cancer.