Define a set of criteria for escalation of care to the inpatient hospice facility for pediatric patients

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Transcription:

WHO WHEN HOW

Define a set of criteria for escalation of care to the inpatient hospice facility for pediatric patients Construct a set of tools to aid in symptom relief in high-acuity pediatric hospice patients

Medical Child Family Community Spiritual Psychosocial http://www.nhpco.org/sites/default/files/public/quality/ped_pall_care%20_standard.pdf.pdf

https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2014-a.pdf

https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf

http://bmcpalliatcare.biomedcentral.com/articles/10.1186/1472-684x-7-10 http://static.wixstatic.com/media/e37642_380c74d6fc0d43e6a67b6303dfd9a72a.png/v1/fill/w_474,h_484,al_c/e37642_380c74d6fc0d43e6a67b6303dfd9a72a.png

http://www.nhpco.org/sites/default/files/public/quality/ped_pall_care%20_standard.pdf.pdf

Function Time

Function Time

Function Time

Function Time

Function Time

Identify the demographics and characteristics of pediatric patients eligible for hospice enrollment Construct a set of tools to aid in symptom relief in high-acuity pediatric hospice patients

http://www.nhpco.org/sites/default/files/public/regulatory/gip_tip_gip_sheet.pdf

http://www.nhpco.org/resources/concurrent-care-children http://www.nhpco.org/sites/default/files/public/chipps/continuum_briefing.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3771494/ http://thorax.bmj.com/content/46/12/881.full.pdf+html

Intractable nausea/vomiting Advanced open wounds requiring treatment and monitoring Unmanageable respiratory distress Delirium with behavioral issues Imminent death with skilled nursing needs present

Pain or symptom management that requires frequent adjustments Intractable nausea/vomiting Advanced open wounds requiring treatment and monitoring Unmanageable respiratory distress Delirium with behavioral issues Imminent death with skilled nursing needs present 1) Initiation of an opioid PCA in a patient previously controlled on oral therapy 2) Requiring more than an average of one dose of an as-needed medication per hour

Pain or symptom management that requires frequent adjustments Intractable nausea/vomiting Advanced open wounds requiring treatment and monitoring Unmanageable respiratory distress Delirium with behavioral issues Imminent death with skilled nursing needs present 1) Initiation of an opioid PCA in a patient previously controlled on oral therapy 2) Requiring more than an average of one dose of an as-needed medication per hour 3) Continued emesis despite routine use of first- and second-line medications in the home 4) Vomiting that results in less than 2 normally wet diapers over a 24 hour period of time

Pain or symptom management that requires frequent adjustments Intractable nausea/vomiting Advanced open wounds requiring treatment and monitoring Unmanageable respiratory distress Delirium with behavioral issues Imminent death with skilled nursing needs present 1) Initiation of an opioid PCA in a patient previously controlled on oral therapy 2) Requiring more than an average of one dose of an as-needed medication per hour 3) Continued emesis despite routine use of first- and second-line medications in the home 4) Vomiting that results in less than 2 normally wet diapers over a 24 hour period of time 5) Severe dyspnea not relieved by appropriate doses of Morphine, or equivalent 6) Respiratory distress resulting in an inability to tolerate oral intake

Identify the demographics and characteristics of pediatric patients eligible for hospice enrollment Define a set of criteria for escalation of care to the inpatient hospice facility for pediatric patients Construct a set of tools to aid in symptom relief in high-acuity pediatric hospice patients

http://www.nejm.org/doi/full/10.1056/nejm200002033420506#t=article

http://onlinelibrary.wiley.com/doi/10.1592/phco.28.6.788/abstract http://www.europeanreview.org/article/4900

http://annonc.oxfordjournals.org/content/10/12/1511.full.pdf Fast Facts and Concepts #53 Sublingual Morphine

https://www.ncbi.nlm.nih.gov/pubmed/20413056 Fast Facts and Concepts #27 Dyspnea at End-of-Life

http://www.jpsmjournal.com/article/s0885-3924(97)00263-7/pdf Fast Facts and Concepts #5 The Causes of Nausea and Vomiting

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/69200/22413_ftp.pdf?sequence=1&isallowed=y

https://pedsinreview.aappublications.org/content/35/9/390

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