Palliative Social Work in the Emergency Department

Lawson, Robin

doi:10.1080/15524256.2012.685427

Cited by 12 publications

(10 citation statements)

References 14 publications

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“… 69 Second, a collaborative relationship means that social workers can advocate for the early integration of palliative care in clients’ treatment trajectory. 68 , 70 Third, social workers can be better intermediaries between a client and the multidisciplinary team in case of a good collaborative relationship. 18 , 62 , 67 , 70 , 71 This is important to perform typical social work tasks in palliative care such as facilitating difficult client–physician conversations 43 or addressing the needs of clients who do not understand the medical jargon.…”

Section: Resultsmentioning

confidence: 99%

How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice

et al. 2021

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Palliative care is a holistic practice using a multidisciplinary approach in addressing multidimensional needs. Although the social aspects surrounding the end-of-life phase suggest a place for social work in it, the profession is often inadequately involved in daily practice. This contrasts strongly with the potential meaningful contributions of social workers in this field. To date, no comprehensive list of prerequisites for meaningful social work involvement in palliative care exists. This review aims to gain more insight on the prerequisites for meaningful social work involvement in palliative care and how to realise them in practice. It could therefore provide pathways for future intervention development in enhancing the involvement of social workers and maximising their contributions in palliative care. A scoping review methodology was used. A systematic selection of peer-reviewed articles ranged from 2000 to April 2021 – out of the electronic databases Web of Science, Scopus and Pubmed – was conducted. The 170 articles that met the eligibility criteria were analysed for relevant content using open and axial coding processes. The findings are reported according to the PRISMA-ScR checklist. The nine prerequisites listed in this review concern the level of individual social work capacities and the level of contextual factors structuring social work practices. A majority of articles have, however, focused on the level of individual social work capacities in a rather specialist view on palliative care. Future research should further address the contextual level of social work involvement in the broader practice of death, dying and bereavement.

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Section: Resultsmentioning

confidence: 99%

How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice

et al. 2021

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“…The interviewees suggested that a prompt to establishing GOC, such as when treatment is no longer achieving desired goals, changed the goals from implicit, or system defaults, to explicit. There was strong evidence that GOC should be discussed and decided upon before an emergency (Weissman , Volicer ), which was supported by emergency room and intensive care unit physicians (Lawson , National Center for Ethics in Healthcare ).…”

Section: Resultsmentioning

confidence: 99%

Goals of care: a concept clarification

Stanek

2017

Journal of Advanced Nursing

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Development of clear goals of care can increase patient satisfaction and quality of care while decreasing costs, hospital length of stay and hospital readmission. Goals of care are dynamic and should be reassessed regularly. How and when goals of care transition from implicit to explicit should be explored further, and what prompts this transition. Nurses, physicians and healthcare providers need education on how to best fill their roles in the development of goals of care.

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“…An increasing number of palliative and emergency medicine departments are collaborating to improve ED care for patients in their final hours in order to initiate palliative care consults earlier. 27 Social work models, such as palliative care service-initiated programmes, palliative care champions in the ED, and an ED-hospice partnership for hospice services, 28 were created specifically to recognise patients with palliative needs in order to increase their comfort level in their final hours. However, the study found a lack of involvement of the MSWs and palliative team, possibly due to the lack of time and the presence of logistical constraints.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study on end-of-life care in the emergency department of a tertiary hospital in Singapore

Goh

Jaffar

et al. 2020

Proceedings of Singapore Healthcare

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Introduction: The emergency department receives a whole breadth of patient types. Those who are imminently dying may attend the emergency department in the hours or days leading up to their demise, necessitating the initiation of end-of-life care in the emergency department. Aim: The aim of our study was to describe the characteristics and management of imminently dying patients who had presented to our emergency department to identify opportunities for improvement in the provision of end-of-life care in the emergency department. Methods: A retrospective study involving patients who died in the emergency department within 48 hours of registration presenting between 1 January 2018 and 31 December 2018 was carried out. Results: Out of 59 included patients, 91.5% had pre-existing medical conditions; 25.4% had end-stage organ failure of which renal and cardiac were most common. Only 15.3% had preferred care plans documented and among these, only a minority (33.3%) had undergone formal advance care planning. The most common presenting symptom among patients who died within 48 hours was dyspnoea (44.1%). The most common investigation done was capillary blood glucose (84.7%) and the most common procedure was an intravenous peripheral cannula insertion (84.7%). Antibiotics were given in 30.5% of the patients and fentanyl was administered in 20.3% for symptom control. Conclusion: The majority of patients presenting to the emergency department within hours or days of their demise had pre-existing chronic or terminal conditions but only a few had specified their preferences for end-of-life care. Investigations and procedures that do not affect patient comfort or outcomes should be minimised.

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Palliative Social Work in the Emergency Department

Cited by 12 publications

References 14 publications

How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice

How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice

Goals of care: a concept clarification

A retrospective study on end-of-life care in the emergency department of a tertiary hospital in Singapore

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