The Impact of Pediatric Palliative Care Involvement in the Care of Critically Ill Patients without Complex Chronic Conditions.
J Palliat Med
; 22(5): 553-556, 2019 05.
Article
en En
| MEDLINE
| ID: mdl-30589623
ABSTRACT
Background:
The impact of pediatric palliative care (PPC) is well established for children with chronic complex diseases. However, PPC likely also benefits previously healthy children with acute life-threatening conditions.Objective:
To determine the incidence and impact of PPC for previously healthy patients who died in a pediatric hospital.Design:
Retrospective chart review of all pediatric deaths over four years. Setting/Subjects:
Patients were 0 to 25 years old, died during an inpatient stay at an academic pediatric hospital ≥48 hours after admission, and had no complex chronic conditions (CCCs) before admission. Measurements One hundred sixty-seven patients met the eligibility criteria. Most died in intensive care settings (n = 149, 89%), and few (n = 34, 20%) received PPC consultations or services.Results:
Patients who received PPC services were more likely to receive a multidisciplinary care conference than did patients without PPC support (70.5% vs. 39.9%; p = 0.001), which also occurred earlier for patients who received PPC services (seven days vs. two days before death; p = 0.04). Most patients had documented end-of-life planning in their medical records; however, this occurred earlier for patients who received PPC consultation (9.5 days before death) than for those who did not (two days before death; p < 0.0001). Patients receiving PPC support (67.7%) were also more likely to have a do-not-resuscitate/intubate order before death than those who did not (39.9%; p = 0.004).Conclusions:
Pediatric patients without known CCCs who subsequently die as inpatients benefit from PPC in terms of goals of care discussions and documentation of end-of-life care preferences.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
2_muertes_prevenibles
/
7_non_communicable_diseases
Asunto principal:
Cuidados Paliativos
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Enfermería Pediátrica
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Cuidado Terminal
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Unidades de Cuidado Intensivo Pediátrico
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Enfermedad Aguda
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Enfermería de Cuidados Paliativos al Final de la Vida
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
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Child
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Child, preschool
/
Female
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Humans
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Infant
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Male
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Newborn
Idioma:
En
Revista:
J Palliat Med
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2019
Tipo del documento:
Article