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CAPC Palliative Care Discussion Forum
Hospital and Hospice Partnerships

Next Reply: Re:transitional care
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Post transitional care
Author: Browha
Date: Oct 6, 2011 10:03 pm
I am a member of an inpatient palliative care consult team. We have a 16 bed inpatient palliative care unit. We are having difficulties with transitioning patients that we withdraw life support on from the ICU to PCU (palliative care unit) as many are living longer than 24 hr following withdraw. Our current policy has us move pts from PCU to outside IPU hospice facility. Many families are becoming very upset with moving pt to outside facility after withdrawing life support 24 hrs prior to this. How do you handle transitions like this? What are your policies? Does your facility allow hospice in your PCU? All input appreciated!!!
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+ Re:transitional care (by PCoyne on 10/11/2011)
We have had this same problem; we approach this with an up-front discussion pre-extubation about the role of palliative care and our role to comfort the patient (as well as the family). However, we state up front that should your loved one stabilize alternate site of care such as inpatient hospice will need to be reviewed; if patient is stable post-extubation in the ICU without symptoms it is not uncommon to transfer directly to inpatient hospice. We never will transfer an unstable patient there.
Patrick Coyne, MSN, APRN, FAAN
Clinical Director
Thomas Palliative Care Program
VCU Health System/VCU Massey Cancer Center

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