A “Three-Stage Protocol” for Serious Illness Conversations

Lu, Emily; Nakagawa, Shunichi

doi:10.1016/j.mayocp.2020.02.005

Cited by 12 publications

(9 citation statements)

References 12 publications

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“…The palliative care team (1 attending physician who was board-certified in hospice and palliative medicine, 1 hospice/palliative medicine fellow clinician, and 4 psychiatry resident physicians and fellow clinicians, all trained in GOC conversations and supervised by the palliative care attending physician) was available in person 12 hours per day, and for phone consultation overnight and on weekends. The palliative care intervention focused on GOC conversations: conveying the prognosis in a clear and simple way, exploring patients’ goals and values, and making care recommendations based on elicited goals …”

Section: Methodsmentioning

confidence: 99%

“…The palliative care intervention focused on GOC conversations: conveying the prognosis in a clear and simple way, exploring patients' goals and values, and making care recommendations based on elicited goals. 1,2 Deidentified demographic data were collected from the medical record. Primary outcomes included GOC before and after palliative care intervention, as well as GOC on death or discharge.…”

Section: Early Intervention Of Palliative Care In the Emergency Deparmentioning

confidence: 99%

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Early Intervention of Palliative Care in the Emergency Department During the COVID-19 Pandemic

et al. 2020

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Section: Methodsmentioning

confidence: 99%

Section: Early Intervention Of Palliative Care In the Emergency Deparmentioning

confidence: 99%

Early Intervention of Palliative Care in the Emergency Department During the COVID-19 Pandemic

et al. 2020

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“…The healthcare pro- From another perspective, using a template or communication protocol while conveying bad news is recommended to ensure professional and empathetic communication with patients and their families (Rosenzweig, 2012). There are several published tools and protocols to guide professionals on disclosing serious illnesses (Baile et al, 2000;Buckman, 1992aBuckman, , 1992bLu & Nakagawa, 2020;Rosenzweig, 2012). Systematic research may be used by professionals in Jordan and other countries, to culturally adopt and examine the utility of these tools in guiding the clinical practice in ICUs.…”

Section: Rele Van Ce To Clini C Al Pr Ac Ti Cementioning

confidence: 99%

Communicating prognostic information and hope to families of dying patients in intensive care units: A descriptive qualitative study

Almansour

Razeq

2021

Journal of Clinical Nursing

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Aims and objectives To understand how prognostic information is communicated by Jordanian doctors and nurses to the families of dying patients in intensive care units, with an emphasis on exploring how hope and truth telling about patients' poor prognosis are managed. Background Improving end‐of‐life care requires a focus on adequate family–professionals prognostic communication, while maintaining a realistic level of hope and family support. Design A descriptive qualitative approach was applied. Methods Semi‐structured interviews were conducted with 20 nurses and 15 resident doctors caring for dying patients. Bardin's procedure of categorical content analysis was applied. The COREQ checklist for reporting qualitative studies was followed. Results Two main categories emerged from the data of this study: ‘perspectives on optimistic hope’ and ‘approaches to prognostic communication’. Health professionals experience extreme difficulty, and therefore, frequently avoid openly disclosing information about patients' poor prognosis to the families. Consequently, the health professionals adopted various methods to balance truth telling against sustaining hope among the patients' families. Providing false assurance was perceived as permissible and understandable, in order to nurture the families' hope. Conclusions Improving end‐of‐life care in intensive care units in Jordan requires a focus on family–professional communication. Jordanian intensive care doctors and nurses perceived honest family–professional communication regarding dying patients to be extremely challenging. Healthcare professionals should develop their competency of meeting the informational and emotional needs of patients in ICUs and their families, while also honouring their cultural values, during prognostic communication. Relevance to clinical practice Effective training of healthcare professionals is vital on ways to enhance communication of prognostic information and to foster realistic hope among families of dying patients in intensive care units. There is a need to also explore the families' perspectives on prognostic communication in order to understand the similarities and differences between the professionals' and families' perspectives.

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“…It is a necessity of the time that in ED there is a palliative care space, but it is necessary that emergency physicians should receive of icial training on how to manage palliative patients, this will contribute and help reduce ED overcrowding. Patients with oncological and palliative problems in ED, after receiving, monitoring, observation, laboratory diagnosis, radiology and medical consultations, with decision-making were systematized according to the diagnosis and treatment unit for further treatment according to the pathology of the disease [7,8]. After the palliative care intervention the criteria of BLS were determined, ACLS "Do not do resuscitation alone" (follow all the principles of palliative care except CPR), do not intubate, continue the symptomatic medical treatment "(follow all the steps of palliative care) excluding intubation and CPR); and taking care directed only at relieving pain and psychological and social problems [9].…”

Section: Resultsmentioning

confidence: 99%

Emergency care sick palliative and problems oncology in emergency department during the COVID-19 pandemic

Lenjani¹,

Baftiu²,

Rashiti³

et al. 2020

Arch Pathol Clin Res

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Emergency medical care in palliative patients during the COVID-19 pandemic, it is important to provide a consistent treatment for stable patients that should be consistent with the goals and benefits, the perspective of these patients, but avoiding palliative patients with a poor prognosis that is unlikely to survive. Cancer is the second leading cause of death in the world around 8.8 million deaths a year. Worldwide, about 7-10 million patients are diagnosed with cancer each year, recently there has been a significant increase in the number of cases diagnosed with cancer. About 70% of cancer deaths are in low- and middle-income countries. The goals of emergency medical care based on the criteria of BLS and ACLS, that is should be done “Do not do resuscitation, do not intubate but continue medical treatment excluding endotracheal intubation without prospects for the patient, but offering BLS only treatment concentrated symptomatic. ED is often the only place that can provide the necessary medical interventions (e.g., intravenous fluids or pain management medications. Medications as well as immediate access to advanced diagnostic tests when needed such as CT, RM and other diagnostic and treatment procedures.

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A “Three-Stage Protocol” for Serious Illness Conversations

Cited by 12 publications

References 12 publications

Early Intervention of Palliative Care in the Emergency Department During the COVID-19 Pandemic

Early Intervention of Palliative Care in the Emergency Department During the COVID-19 Pandemic

Communicating prognostic information and hope to families of dying patients in intensive care units: A descriptive qualitative study

Emergency care sick palliative and problems oncology in emergency department during the COVID-19 pandemic

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