BACKGROUND: To add to the data regarding the quality of care given to dying children and their families. OBJECTIVE: To develop baseline of end-of-life care at a single pediatric facility to evaluate institution-wide palliative care initiative. DESIGN: Retrospective chart review of all known deaths during an 18-month time period. SETTING/ SUBJECTS: One hundred forty-five charts of patients from a single pediatric cancer facility who died during designated time period. MEASUREMENTS: Variables included: cause and place of death; CPR/DNR status prior to death; length of end of life care prior to death; sibling counseling and bereavement counseling offered to family after death; and wishes or preferences of patient/family regarding the death experience. RESULTS: Results included: solid tumor patients more likely to die of progressive disease than leukemia or bone marrow transplant patients; bone marrow transplant patients 2-3 times more likely to die of cardiopulmonary or cardiovascular complications; solid tumor patients were more likely to die at home than leukemia patients; solid tumor/brain tumor patients had a median time in end of life or palliative care of 29 days compared to leukemia patients' median of 11 days; 48% of DNRs completed 11 days prior to death. CONCLUSIONS: Relationship exists between diagnosis, cause and place of death in this population; findings replicate findings of 4 similar studies; accurate and consistent quality standards of care need to be established for this population as well as methods of documentation before reviewing/accrediting agencies impose standards that are not evidence based.
BACKGROUND: To add to the data regarding the quality of care given to dying children and their families. OBJECTIVE: To develop baseline of end-of-life care at a single pediatric facility to evaluate institution-wide palliative care initiative. DESIGN: Retrospective chart review of all known deaths during an 18-month time period. SETTING/ SUBJECTS: One hundred forty-five charts of patients from a single pediatric cancer facility who died during designated time period. MEASUREMENTS: Variables included: cause and place of death; CPR/DNR status prior to death; length of end of life care prior to death; sibling counseling and bereavement counseling offered to family after death; and wishes or preferences of patient/family regarding the death experience. RESULTS: Results included: solid tumorpatients more likely to die of progressive disease than leukemia or bone marrow transplant patients; bone marrow transplant patients 2-3 times more likely to die of cardiopulmonary or cardiovascular complications; solid tumorpatients were more likely to die at home than leukemiapatients; solid tumor/brain tumorpatients had a median time in end of life or palliative care of 29 days compared to leukemiapatients' median of 11 days; 48% of DNRs completed 11 days prior to death. CONCLUSIONS: Relationship exists between diagnosis, cause and place of death in this population; findings replicate findings of 4 similar studies; accurate and consistent quality standards of care need to be established for this population as well as methods of documentation before reviewing/accrediting agencies impose standards that are not evidence based.
Authors: Justin N Baker; Shesh Rai; Wei Liu; Kumar Srivastava; Javier R Kane; Christine A Zawistowski; Elizabeth A Burghen; Jami S Gattuso; Nancy West; Jennifer Althoff; Adam Funk; Pamela S Hinds Journal: J Palliat Med Date: 2009-01 Impact factor: 2.947
Authors: Erica C Kaye; Samantha DeMarsh; Courtney A Gushue; Jonathan Jerkins; April Sykes; Zhaohua Lu; Jennifer M Snaman; Lindsay J Blazin; Liza-Marie Johnson; Deena R Levine; R Ray Morrison; Justin N Baker Journal: Oncologist Date: 2018-05-04
Authors: Veronica Dussel; Ulrika Kreicbergs; Joanne M Hilden; Jan Watterson; Caron Moore; Brian G Turner; Jane C Weeks; Joanne Wolfe Journal: J Pain Symptom Manage Date: 2008-06-06 Impact factor: 3.612