Palliative Care Screening and Assessment in the Emergency Department

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: closed (30 March 2021) | Viewed by 4807

Special Issue Editor

Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 18016 Granada, Spain
Interests: burnout; critical care; emergency; Job Satisfaction; nursing; occupational health; public health; stress
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Special Issue Information

Dear Colleagues,

Medicina is currently receiving manuscripts for a Special Issue on palliative care screening and assessment in the emergency department. The Special Issue will include manuscripts on variables related to palliative care in emergency departments (ER).

According to the World Health Organization (WHO), 40 million people need palliative care every year. These cares prevent and alleviate suffering through early identification, the correct treatment of pain, and other related problems. Patients who most need palliative care have chronic diseases and often go to the ER frequently. Normally, these patients suffer exacerbations of their disease, complications, or need pain relief. In fact, professionals must be trained in palliative care to improve the quality of life of these patients. Therefore, analyzing different variables related to the admission of these patients in the ER is important to be able to treat them efficiently.

We welcome studies using quantitative, qualitative, or mixed methods, with primary or secondary data. All articles are subject to peer review to ensure quality publications. For more information, please contact Guillermo A. Cañadas-De la Fuente ([email protected]).

Prof. Dr. Guillermo A. Cañadas-De la Fuente
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Emergency department
  • Health professionals
  • Mental health
  • Occupational health
  • Palliative care
  • Quality of life
  • Risk factors
  • Workplace policies

Published Papers (2 papers)

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Research

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15 pages, 365 KiB  
Article
Frailty, Complexity, and Priorities in the Use of Advanced Palliative Care Resources in Nursing Homes
by Emilio Mota-Romero, Beatriz Tallón-Martín, María P. García-Ruiz, Daniel Puente-Fernandez, María P. García-Caro and Rafael Montoya-Juarez
Medicina 2021, 57(1), 70; https://doi.org/10.3390/medicina57010070 - 14 Jan 2021
Cited by 8 | Viewed by 2308
Abstract
Background and objectives: This study aimed to determine the frailty, prognosis, complexity, and palliative care complexity of nursing home residents with palliative care needs and define the characteristics of the cases eligible for receiving advanced palliative care according to the resources available at [...] Read more.
Background and objectives: This study aimed to determine the frailty, prognosis, complexity, and palliative care complexity of nursing home residents with palliative care needs and define the characteristics of the cases eligible for receiving advanced palliative care according to the resources available at each nursing home. Materials and Methods: In this multi-centre, descriptive, and cross-sectional study, trained nurses from eight nursing homes in southern Spain selected 149 residents with palliative care needs. The following instruments were used: the Frail-VIG index, the case complexity index (CCI), the Diagnostic Instrument of Complexity in Palliative Care (IDC-Pal), the palliative prognosis index, the Barthel index (dependency), Pfeiffer’s test (cognitive impairment), and the Charlson comorbidity index. A consensus was reached on the complexity criteria of the Diagnostic Instrument of Complexity in Palliative Care that could be addressed in the nursing home (no priority) and those that required a one-off (priority 2) or full (priority 1) intervention of advanced palliative care resources. Non-parametric tests were used to compare non-priority patients and patients with some kind of priority. Results: A high percentage of residents presented frailty (80.6%), clinical complexity (80.5%), and palliative care complexity (65.8%). A lower percentage of residents had a poor prognosis (10.1%) and an extremely poor prognosis (2%). Twelve priority 1 and 14 priority 2 elements were identified as not matching the palliative care complexity elements that had been previously identified. Of the studied cases, 20.1% had priority 1 status and 38.3% had priority 2 status. Residents with some kind of priority had greater levels of dependency (p < 0.001), cognitive impairment (p < 0.001), and poorer prognoses (p < 0.001). Priority 1 patients exhibited higher rates of refractory delirium (p = 0.003), skin ulcers (p = 0.041), and dyspnoea (p = 0.020). Conclusions: The results indicate that there are high levels of frailty, clinical complexity, and palliative care complexity in nursing homes. The resources available at each nursing home must be considered to determine when advanced palliative care resources are required. Full article
(This article belongs to the Special Issue Palliative Care Screening and Assessment in the Emergency Department)

Review

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12 pages, 778 KiB  
Review
Nurses Training and Capacitation for Palliative Care in Emergency Units: A Systematic Review
by Sonia Ortega Romero, Almudena Velando-Soriano, José Luis Romero-Bejar, Keyla Vargas-Román, Luis Albendín-García, Nora Suleiman-Martos and Guillermo Arturo Cañadas-De la Fuente
Medicina 2020, 56(12), 648; https://doi.org/10.3390/medicina56120648 - 26 Nov 2020
Cited by 2 | Viewed by 2023
Abstract
Background and objectives: Palliative care (PC) prevents and alleviates patients´ suffering to improve their quality of life in their last days. In recent years, there has been an increase in visits to the emergency services (ES) by patients who may need this type [...] Read more.
Background and objectives: Palliative care (PC) prevents and alleviates patients´ suffering to improve their quality of life in their last days. In recent years, there has been an increase in visits to the emergency services (ES) by patients who may need this type of care. The aims were to describe the training and capacitation of nurses from ES in PC. Accordingly, a systematic review was performed. Materials and Methods: Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used. The search equation was “Palliative care and nursing care and emergency room”. A total of 12 studies were selected. Results: The studies agree on the need for training professionals in PC to provide a higher quality care, better identification of patient needs and to avoid unnecessary invasive processes. Similarly, the implementation of a collaborative model between ES and PC, the existence of a PC specialized team in the ES or proper palliative care at home correspond to a decrease in emergency visits, a lower number of hospitalizations or days admitted, and a decrease in hospital deaths. Conclusions: The development of PC in the different areas of patient care is necessary. Better palliative care leads to a lower frequency of ES by terminal patients, which has a positive impact on their quality of life. Access to PC from the emergency unit should be one of the priority health objectives due to increment in the aged population susceptible to this type of care. Full article
(This article belongs to the Special Issue Palliative Care Screening and Assessment in the Emergency Department)
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