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CAPCconnect™ palliative care discussion forum

Palliative Care and the ICU


Number of threads on this Forum: 56
Next 29 items »
Subject Author Posts Last Post
Description
Post Propofol policies - extubation to comfort care drosielle 3 05/16/2013
I am being asked to speak at my institution's adult critical care committee about allowing propofol to be used for symptom control in patients who are being extubated to comfort care with the expectation they will die quickly. Currently, the institution f ...
Post PALLIATIVE CARE BILLING mmoroney 1 04/11/2013
Let me start by explaining, I am new to palliative care billing. Normally when billing a evaluation and management code, the chief compliant assists in establishing the medical necessity of a visit. With PC, when a provider sees a patient for comfort ca ...
Post Locked-in Syndrome WRNFNP 1 01/04/2013
Does anyone know of any good articles discussing Palliative Care and Locked-in Syndrome?
Post Exam Review Audio Cd polive 1 11/30/2012
Does anyone know of review cd's for the Hospice and Palliative Care Certification Exam (RN-nursing level) Thanks in advance, Phyllis Olive, RN polive@hughes.net
Post Readmissions and Mortality ChristieHerrick 2 12/07/2012
Hi - we have had some of our hospital partners state that if a patient is receiving palliative services in the hospital a death will not count against their mortality. And a new assumption that a few physicians have raised is that if the patient is in o ...
Post Readmissions and Mortality ChristieHerrick 2 11/30/2012
Hi - we have had some of our hospital partners state that if a patient is receiving palliative services in the hospital a death will not count against their mortality. And a new assumption that a few physicians have raised is that if the patient is in o ...
Post Readmissions and Mortality ChristieHerrick 4 12/03/2012
Hi - we have had some of our hospital partners state that if a patient is receiving palliative services in the hospital a death will not count against their mortality. And a new assumption that a few physicians have raised is that if the patient is in o ...
Post Palliative care in the ICU Ukhan 2 10/30/2012
Our hospital has partnered with a major health insurance carrier on a palliative care initiative in the ICU. There is fair amount of resistance and the number of consults are low from the ICU. A form for the family meeting and goals of care conversation h ...
Post IPAL/Critical Care Kathi 4 10/11/2012
Can those hospitals who are running the IPAL program model in their hospitals identify themselves? It would be helpful to have a conversation with someone who is actively implementing this program with regard to successes and difficulties. Thank you.
Post No Escalation of Care hstuch 3 06/22/2012
Does anyone have a policy on "no escalation of care" in the ICU. We want to be able to clarify and standardize which inetrventions should not be offered or initiated in a patient with a poor prognois in the unit.
Post PC triggers for eICU cblais 3 05/30/2012
We have begun using an eICU to remotely monitor ICU patients, after hours, at several of our system hospitals. Other than the triggers already noted in the Portfolio and the article by Nelson, et al in CCM, does anyone have any experience with triggers in ...
Post ICU leaflet DeannaBrame 2 05/02/2012
We are moving forward with ICU PC project and following care and communication quality measures, which includes giving patient/family ICU information leaflet. Does anyone have one to share? I see one posted in capc resources from Mount Carmel, any others ...
Post nurse driven PC protocols? mcornell 2 03/26/2012
Have any of you implemented any nurse driven protocols in support of your palliative care program, e.g. nurse-driven protocol to order palliative consult; drive driven order to initiative PC standing orders, etc....?
Post what is IPAL -ICU lambert 2 02/07/2012
hi i am doing my BSc hons and my project is about the intergration of palliative care into ICU i have been reading about IPAL-ICU and wondered if anyone can tell me how this came about and why
Post Partial DNR's Deb 2 01/25/2012
Hi, My group of intensivists are finally getting fed up with partial DNR orders, like chemical code only. There are only a few physicians still writing this and these are usually the physicians who resist allowing palliative care involvement too, so I hav ...
Post ICU LOS akrause 6 10/31/2012
Two questions: Does anyone have data on how much a proactive palliative care consult impacts a PC service LOS? Hospital administrators are looking at the total LOS but if PC gets involved on HD #2, after a positive palliative care screen, our LOS increas ...
Post subcutaneous catheter policies ultrapollo08 1 08/29/2011
We are beginning to provide more acute palliative care to our patients and would like to adopt a subcutaneous catheter infusion policy. I have a sample for our local hospice but was wondering if someonw could share this policy with me. I am challenged to ...
Post ICU/PC Representation on Ethics Committees HilliardB 7 12/02/2011
Looking for information on ICU or palliative care representation on the institution's ethics committee. If your hospital has an "active and effective" committee, does anyone from ICU or the palliative care service serve as a member?
Post Written Consent to withhold withdraw life support ultrapollo08 2 08/24/2011
In Nevada we have a law that requires written consent to withhold or withdraw life support. Can someone share with me the laws governing this in the state they practice in? I am working with legislation to change this to implied consent NRS 449.626 ...
Post Palliative Care in CCU HilliardB 2 08/08/2011
One way to increase requests for PC consults is to ask for help from the hospital's ethics committee. Ethics committees have a variety of strategies and ideas for instituting "culture change" and helping physicians and families see the value of PC.
Post pt in denial and upset about talking about illness maryg 3 08/04/2011
elderly female with lung cancer and in ICU with sob referal to discuss goals of care. When I spoke with patient she stated she could never discuss if she would want to stop aggressive therapy. I agreed I would not bring up again since was upsetting. Went ...
Post ICU palliative care barriers in nursing care ICU_nurse 4 06/20/2011
Working in the medical ICU, I still do not see enough palliative care consults (and we have a wonderful palliative care team in the hospital). How does one initiate a "culture change?"
Post CRRT ultrapollo08 5 04/22/2011
I am looking for a standard to base the need to initiate CRRT in the ICU. Does anybody use the APACHE II scoring system and predictor of outcomes? If so at what score triggers a case conference or do you require them of all cases prior to starting CRRT?
Post automatic referasl in ICU maryg 2 03/11/2011
I was just apporoached by our Citical Care Medical Director that he would like me to develope of propossl on automatic referals for PC in the ICU. Love the idea but feel a little overwhelmed with the task and where to start. Anyone have any suggestions?
Post DOH: Palliative Care Information ACT New York Stat Laura 2 03/14/2011
The palliative care information act just became law in NY state on 2/9/11 requiring attending physicians and NPs to offer "terminally ill" (defined as having a condition likely to cause death within 6 months) patients counseling and information regarding ...
Post Who can initiate a DNR/Treatment limitation order? jgoodill 2 02/11/2011
I am a palliative care physician and have been involved in designing our DNR order form/policy. currently we allow residents to initiate a DNR as long as the attending signs it within 24 hrs. more recently we have allowed APN/Pas to do the same. How do ...
Post Palliative Performance Score use in ICU setting jward10450 2 02/09/2011
We have just starting a pilot tracking PPS in our inpatient consultation service with the hope to tie scores to survival data and benchmark against some of the published works using this tool in the cancer population. Obviously this does not translate we ...
Post 3 New Tools Posted on IPAL-ICU! PCaines 1 01/03/2011
Dear Forum Community: I want to alert you about following 3 new tools posted to our IPAL-ICU website: 1 -- Clinician Satisfaction Survey (Ann Arbor VA) as posted under the section entitled, "Quality Monitoring Tools" 2 -- ICU Pall Care Service Ag ...
Post organ donation for terminal extubation patients s2white 6 05/16/2012
Our Palliative Care Service is involved in some but not all terminal weans in the ICU's. Up to now, Spiritual Care has discussed organ donation with the families. We do have a chaplain on our team, but he does not feel comfortable or competent to discuss ...
Post Heart Transplant and LVAD patients cblizzard 3 12/07/2010
Does anyone have experience in working with heart transplant and LVAD teams?
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