Articles: palliative-care.
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Complexities of Corona Virus Disease-19: The Role of Palliative Care at a Veterans Affairs Hospital.
The Corona Virus Disease-19 (COVID-19) pandemic accentuated the need for delivery of quality palliative care. We share the experience of our acute care hospital palliative care team in caring for veteran patients who died from COVID-19 and provide recommendations for palliative care teams caring for older adult populations. ⋯ They were medically and psychosocially complex with 75.8% carrying at least four medical comorbidities, 87.8% presenting from an institutional facility, and 39.4% diagnosed with at least one psychiatric condition. Our results emphasize the impact of this pandemic on vulnerable populations and highlight the benefits of palliative care for support of patients, their loved ones, and the clinical teams caring for them.
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Opportunities for advanced practice registered nurses (APRNs) to train for specialty palliative care practice are insufficient to meet workforce needs. Graduate nursing programs in the United States do not have uniform or required curricula in palliative and end-of-life care of the seriously ill. In clinical practice, APRNs acquire palliative care skills by a mix of on-the-job experience, self-study, and continuing education. ⋯ While these efforts help meet staffing needs and promote interprofessionalism, these programs are built upon medical curricula and competencies rather than grounding from a nursing framework. Nursing fellowship directors may not have the same administrative support, protected nonclinical time, funding, or access to nursing mentors and faculty afforded to their medical counterparts. This article provides a blueprint for clinician educators from nursing or non-nursing disciplines, who want to develop or refine training programs for APRNs that adhere to palliative nursing standards and offer a curriculum integrated with supervised practice and mentorship.
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J Pain Symptom Manage · Sep 2021
Pre-post Evaluation of Collaborative Oncology Palliative Care for Patients with Stage IV Cancer.
The Collaborative Care Model improves care processes and outcomes but has never been tested for palliative care. ⋯ Collaborative oncology palliative care is efficient and feasible. While it did not increase overall goals-of-care discussions, it was effective to increase overall advance care planning and hospice use for patients with Stage IV cancer.
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Palliative medicine · Sep 2021
Nationwide evaluation of palliative care (Q-PAC study) provided by specialized palliative care teams using quality indicators : Large variations in quality of care.
Although a number of quality indicators for palliative care have been implemented worldwide, evidence regarding the performance of palliative care teams is scarce. ⋯ The large risk-adjusted variation found across the quality indicator scores suggest that repeated and standardized quality improvement evaluations can allow teams to benchmark themselves to each other to identify areas of their palliative care delivery that need improvement.
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Pathological fractures are not only incisive events for tumor patients often with the need of surgical treatment but also often represent a relevant challenge in the overall concept of oncological treatment. ⋯ The work-up of the multifaceted oncological treatment concept represents an interdisciplinary challenge, which ideally defines the further treatment procedure, including fracture treatment, in an interdisciplinary tumor board within an overall oncological concept.