ED-PALS: A Comprehensive Palliative Care Service for Oncology Patients in the Emergency Department
| Autor: | Socrates Montalban, Mervyn Yong Hwang Koh, Jia F Lee, Chik Loon Foo, Allyn Hum |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Emergency Medical Services Palliative care Referral Decision Making 03 medical and health sciences 0302 clinical medicine 030502 gerontology Neoplasms Medicine Humans Prospective Studies Referral and Consultation Aged Service (business) Aged 80 and over business.industry General Medicine Emergency department Middle Aged medicine.disease Advanced cancer United States Hospitalization 030220 oncology & carcinogenesis Hospice and Palliative Care Nursing Practice Guidelines as Topic Oncology patients Female Medical emergency 0305 other medical science business |
| Zdroj: | The American journal of hospicepalliative care. 36(7) |
| ISSN: | 1938-2715 |
| Popis: | The American College of Emergency Physicians has identified early palliative care referral for patients with advanced cancer as a key competent of the Choosing Wisely campaign.To study the feasibility of a new 3-way model of care between emergency department (ED), hospital palliative care department, and inpatient/home hospice.This was a prospective, descriptive study that included oncology patients who attended the hospital ED over a 3-year period from January 2015 to December 2017. The inclusion criteria were as follows: (1) presence of metastatic cancer with either; (2) any 1 of the following symptoms: pain, dyspnea, nausea and vomiting, delirium, or swelling; or (3) potential care difficulties (requiring home hospice care or inpatient hospice).A total of 340 patients were referred from the ED. Mean age was 72 years, 59% were males and 41% females, and the majority (88%) were Chinese. The most common cancers were lung 89 (26%), colorectal 71 (21%), and hepatobiliary cancer 49 (14%). The most common symptoms on Edmonton Symptom Assessment Scale scoring were pain (34%), poor appetite (31%), and dyspnea (26%).This tripartite model of palliative care, hospice, and ED collaboration allows earlier access to palliative care in the ED and direct admissions to the palliative care unit and comfort care rooms. The ED patients who did not need admission were also attended to in the palliative care "Hot Clinics" within a week with home hospice help. Patients who required inpatient hospice care were directly admitted there from the ED. |
| Databáze: | OpenAIRE |
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