2.50
Hdl Handle:
http://hdl.handle.net/10755/155802
Type:
Presentation
Title:
End-of-Life Care of Hospitalized Children
Abstract:
End-of-Life Care of Hospitalized Children
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Conference Date:July 10-12, 2003
Author:Gilmer, Mary, MBA, RN, PhD
P.I. Institution Name:Vanderbilt University
Title:Assistant Professor
Co-Authors:Brian Carter, James Whitlock
Objective: Pain and symptom management is an integral part of pediatric palliative care, but little is known about end-of-life care of children. We sought to describe the circumstances surrounding the deaths of terminally ill hospitalized children, especially as they pertain to pain and symptom management by the multidisciplinary pediatric care team.<P> Design: Retrospective medical record review <P> Sample: 105 children (aged 1 day-19 years) who died at Vanderbilt Children's Hospital between July, 2000-June, 2001. <P> Variables: End-of-life management, pain and symptom management, family and child ancillary support<P> Methods: An automated search of computerized records was used to identify all eligible patients. A chart review was completed using an extraction tool adapted from templates used by the City of Hope, Dana-Farber Cancer Institute, and Medical University of South Carolina. <P> Findings: Although death was documented as an expected outcome in 23% of patients, only 2% were considered for hospice referral. DNR orders were written for 42% of patients, CPR was provided in 45%, and 64% of deaths occurred after the withdrawal of artificial life support. Only 26% of patients received a bolus of pain medication and 3% received neuromuscular blocking agents at the time of removing life support. While nearly all children had nutritional support initiated, 23% had it withdrawn prior to their death. 96% of patients had major diagnostic and/or imaging tests performed within 48 hours of their dying. 90% of children received pain medication in the last 72 hrs of life, and 55% received additional comfort care measures. Few children received ancillary services.<P> Conclusions: Although the duration of hospitalization for most children dying in our inpatient setting is sufficient to provide palliative care, many eligible patients did not receive such services. <P> Implications: Findings emphasize importance of exploring initiatives to improve end-of-life care of hospitalized children through practice, research, and education.<!--Abstract 13230 modified by 160.129.131.107 on 10-29-2002--></P></P></P></P></P></P></P>
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Jul-2003
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEnd-of-Life Care of Hospitalized Childrenen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155802-
dc.description.abstract<table><tr><td colspan="2" class="item-title">End-of-Life Care of Hospitalized Children</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 10-12, 2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gilmer, Mary, MBA, RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Vanderbilt University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">maryjo.gilmer@mcmail.vanderbil</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Brian Carter, James Whitlock</td></tr><tr><td colspan="2" class="item-abstract">Objective: Pain and symptom management is an integral part of pediatric palliative care, but little is known about end-of-life care of children. We sought to describe the circumstances surrounding the deaths of terminally ill hospitalized children, especially as they pertain to pain and symptom management by the multidisciplinary pediatric care team.&lt;P&gt; Design: Retrospective medical record review &lt;P&gt; Sample: 105 children (aged 1 day-19 years) who died at Vanderbilt Children's Hospital between July, 2000-June, 2001. &lt;P&gt; Variables: End-of-life management, pain and symptom management, family and child ancillary support&lt;P&gt; Methods: An automated search of computerized records was used to identify all eligible patients. A chart review was completed using an extraction tool adapted from templates used by the City of Hope, Dana-Farber Cancer Institute, and Medical University of South Carolina. &lt;P&gt; Findings: Although death was documented as an expected outcome in 23% of patients, only 2% were considered for hospice referral. DNR orders were written for 42% of patients, CPR was provided in 45%, and 64% of deaths occurred after the withdrawal of artificial life support. Only 26% of patients received a bolus of pain medication and 3% received neuromuscular blocking agents at the time of removing life support. While nearly all children had nutritional support initiated, 23% had it withdrawn prior to their death. 96% of patients had major diagnostic and/or imaging tests performed within 48 hours of their dying. 90% of children received pain medication in the last 72 hrs of life, and 55% received additional comfort care measures. Few children received ancillary services.&lt;P&gt; Conclusions: Although the duration of hospitalization for most children dying in our inpatient setting is sufficient to provide palliative care, many eligible patients did not receive such services. &lt;P&gt; Implications: Findings emphasize importance of exploring initiatives to improve end-of-life care of hospitalized children through practice, research, and education.&lt;!--Abstract 13230 modified by 160.129.131.107 on 10-29-2002--&gt;&lt;/P&gt;&lt;/P&gt;&lt;/P&gt;&lt;/P&gt;&lt;/P&gt;&lt;/P&gt;&lt;/P&gt;</td></tr></table>en_GB
dc.date.available2011-10-26T14:11:15Z-
dc.date.issued2003-07-10en_GB
dc.date.accessioned2011-10-26T14:11:15Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.