Effect of a multidisciplinary ward-based intervention on end-of-life care for general medicine patients
Providing good end-of-life (EOL) care for noncancer patients has been made a national priority in Singapore. A combined medical and nursing ward-based intervention known as the EOL care plan was piloted in a general medicine ward at our institution, aiming to guide key aspects of EOL care. The aim o...
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Veröffentlicht in: | Palliative & supportive care 2022-12, Vol.20 (6), p.813-817 |
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description | Providing good end-of-life (EOL) care for noncancer patients has been made a national priority in Singapore. A combined medical and nursing ward-based intervention known as the EOL care plan was piloted in a general medicine ward at our institution, aiming to guide key aspects of EOL care. The aim of this study is to assess the EOL care plan's effect on EOL care for general medicine patients.
We conducted a retrospective cohort study on inpatients who died in a general ward under the discipline "General Medicine" from May to October 2019. We collected data around symptom management, rationalization of care and communication with families. The primary analysis compared care received by patients who died in the pilot ward with that of a control group of patients who died in other wards.
In total, 112 records were included in the analysis. Pain assessment was more common in the pilot ward compared with the control group (35.3% vs. 6.3%,
< 0.001), as were anti-psychotic prescriptions for delirium (64.7% vs. 24.4%,
= 0.001). Fewer patients received blood glucose monitoring in the last 48 h of life in the pilot ward (69.5% vs. 35.3%,
= 0.007). There were also less frequent parameters monitoring in the pilot ward (
< 0.004).
The implementation of the EOL care plan was associated with process-level indicators of better EOL care, suggesting that it could have a significant positive impact when implemented on a wider scale. |
doi_str_mv | 10.1017/S1478951521001723 |
format | Article |
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We conducted a retrospective cohort study on inpatients who died in a general ward under the discipline "General Medicine" from May to October 2019. We collected data around symptom management, rationalization of care and communication with families. The primary analysis compared care received by patients who died in the pilot ward with that of a control group of patients who died in other wards.
In total, 112 records were included in the analysis. Pain assessment was more common in the pilot ward compared with the control group (35.3% vs. 6.3%,
< 0.001), as were anti-psychotic prescriptions for delirium (64.7% vs. 24.4%,
= 0.001). Fewer patients received blood glucose monitoring in the last 48 h of life in the pilot ward (69.5% vs. 35.3%,
= 0.007). There were also less frequent parameters monitoring in the pilot ward (
< 0.004).
The implementation of the EOL care plan was associated with process-level indicators of better EOL care, suggesting that it could have a significant positive impact when implemented on a wider scale.</description><identifier>ISSN: 1478-9515</identifier><identifier>EISSN: 1478-9523</identifier><identifier>DOI: 10.1017/S1478951521001723</identifier><identifier>PMID: 34663485</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Blood Glucose ; Blood Glucose Self-Monitoring ; Communication ; Death & dying ; Documentation ; Glucose monitoring ; Hospitals ; Humans ; Inpatients ; Integrated delivery systems ; Intensive care ; Medicine ; Multidisciplinary teams ; Nurses ; Nursing care ; Original Article ; Palliative Care ; Patients ; Retrospective Studies ; Teams ; Terminal Care</subject><ispartof>Palliative & supportive care, 2022-12, Vol.20 (6), p.813-817</ispartof><rights>Copyright © The Author(s), 2021. Published by Cambridge University Press</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c325t-cc4a27ed598f868a92431c22652369482789d06f9f78324f45c912e78f114d6b3</cites><orcidid>0000-0003-3482-6954 ; 0000-0002-0822-7504</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1478951521001723/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,780,784,27924,27925,55628</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34663485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Soo Rui Ting, Michelle</creatorcontrib><creatorcontrib>Nashi, Norshima Binte</creatorcontrib><creatorcontrib>Ang Lin Elaine, Kai</creatorcontrib><creatorcontrib>Hooi, Benjamin M.Y.</creatorcontrib><title>Effect of a multidisciplinary ward-based intervention on end-of-life care for general medicine patients</title><title>Palliative & supportive care</title><addtitle>Pall Supp Care</addtitle><description>Providing good end-of-life (EOL) care for noncancer patients has been made a national priority in Singapore. A combined medical and nursing ward-based intervention known as the EOL care plan was piloted in a general medicine ward at our institution, aiming to guide key aspects of EOL care. The aim of this study is to assess the EOL care plan's effect on EOL care for general medicine patients.
We conducted a retrospective cohort study on inpatients who died in a general ward under the discipline "General Medicine" from May to October 2019. We collected data around symptom management, rationalization of care and communication with families. The primary analysis compared care received by patients who died in the pilot ward with that of a control group of patients who died in other wards.
In total, 112 records were included in the analysis. Pain assessment was more common in the pilot ward compared with the control group (35.3% vs. 6.3%,
< 0.001), as were anti-psychotic prescriptions for delirium (64.7% vs. 24.4%,
= 0.001). Fewer patients received blood glucose monitoring in the last 48 h of life in the pilot ward (69.5% vs. 35.3%,
= 0.007). There were also less frequent parameters monitoring in the pilot ward (
< 0.004).
The implementation of the EOL care plan was associated with process-level indicators of better EOL care, suggesting that it could have a significant positive impact when implemented on a wider scale.</description><subject>Blood Glucose</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Communication</subject><subject>Death & dying</subject><subject>Documentation</subject><subject>Glucose monitoring</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Integrated delivery systems</subject><subject>Intensive care</subject><subject>Medicine</subject><subject>Multidisciplinary teams</subject><subject>Nurses</subject><subject>Nursing care</subject><subject>Original Article</subject><subject>Palliative Care</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Teams</subject><subject>Terminal Care</subject><issn>1478-9515</issn><issn>1478-9523</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1UctKBDEQDKK4vj7AiwS8eBnNc5I5ivgCwYN6HrJJZ8kyk1mTGcW_N-KqoAiBTpqq6lQ1QoeUnFJC1dkDFUo3kkpGSXkzvoF2PlpVIxnf_L5TOUO7OS8JYYwTtY1mXNQ1F1ruoMWl92BHPHhscD91Y3Ah27DqQjTpDb-a5Kq5yeBwiCOkF4hjGCIuB6KrBl91wQO2JgH2Q8ILiJBMh3twwYYIeGXGUDh5H21502U4WNc99HR1-XhxU93dX99enN9VljM5VtYKwxQ42Wiva20aJji1jNXFUN0IzYpfR2rfeKU5E15I21AGSntKhavnfA-dfOqu0vA8QR7bvviBrjMRhim3TGouhJBaFejxL-hymFIsv2uZ4kQo2tSsoOgnyqYh5wS-XaXQl2xaStqPLbR_tlA4R2vlaV6S-GZ8xV4AfC1q-nkKbgE_s_-XfQcFOJAR</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Soo Rui Ting, Michelle</creator><creator>Nashi, Norshima Binte</creator><creator>Ang Lin Elaine, Kai</creator><creator>Hooi, Benjamin M.Y.</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3482-6954</orcidid><orcidid>https://orcid.org/0000-0002-0822-7504</orcidid></search><sort><creationdate>20221201</creationdate><title>Effect of a multidisciplinary ward-based intervention on end-of-life care for general medicine patients</title><author>Soo Rui Ting, Michelle ; 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A combined medical and nursing ward-based intervention known as the EOL care plan was piloted in a general medicine ward at our institution, aiming to guide key aspects of EOL care. The aim of this study is to assess the EOL care plan's effect on EOL care for general medicine patients.
We conducted a retrospective cohort study on inpatients who died in a general ward under the discipline "General Medicine" from May to October 2019. We collected data around symptom management, rationalization of care and communication with families. The primary analysis compared care received by patients who died in the pilot ward with that of a control group of patients who died in other wards.
In total, 112 records were included in the analysis. Pain assessment was more common in the pilot ward compared with the control group (35.3% vs. 6.3%,
< 0.001), as were anti-psychotic prescriptions for delirium (64.7% vs. 24.4%,
= 0.001). Fewer patients received blood glucose monitoring in the last 48 h of life in the pilot ward (69.5% vs. 35.3%,
= 0.007). There were also less frequent parameters monitoring in the pilot ward (
< 0.004).
The implementation of the EOL care plan was associated with process-level indicators of better EOL care, suggesting that it could have a significant positive impact when implemented on a wider scale.</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>34663485</pmid><doi>10.1017/S1478951521001723</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-3482-6954</orcidid><orcidid>https://orcid.org/0000-0002-0822-7504</orcidid></addata></record> |
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source | MEDLINE; Cambridge University Press Journals Complete |
subjects | Blood Glucose Blood Glucose Self-Monitoring Communication Death & dying Documentation Glucose monitoring Hospitals Humans Inpatients Integrated delivery systems Intensive care Medicine Multidisciplinary teams Nurses Nursing care Original Article Palliative Care Patients Retrospective Studies Teams Terminal Care |
title | Effect of a multidisciplinary ward-based intervention on end-of-life care for general medicine patients |
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