Bold Voices - March 2013 - (Page 12)

AT THE BEDSIDE Early Communication About Resuscitation Improves EOL Quality Early communication regarding do not resuscitate (DNR) orders helps improve quality at end of life (EOL) among surgical intensive care patients, says a study in the Journal of Pain and Symptom Management. “Changing End-of-Life Care Practice for Liver Transplant Service Patients: Structured Palliative Care Intervention in the Surgical Intensive Care Unit (SICU)” states that early communication between physicians and families, along with earlier integration of palliative care, provides patients with more time to deal with personal issues before their death. In the prospective, observational study of patients in the SICU who had a liver transplant (LT), researchers assessed them before and after a palliative care intervention. The two-part intervention began at admission (Part I), with family support, prognosis and patient preference delineation. Part II, Earlier integration of palliative care an interdisciplinary family meeting that discussed goals, DNR orders and family perception, took place within 72 hours of gives patients more time to deal admission. with personal issues before death. Historically, discussion regarding EOL care could result in conflict, but “early psychosocial support may be critical for future end-of-life discussions, particularly in the LT population where there are high hopes/expectations of life-saving surgery and usually no prior approach to advance care planning,” says Anne Mosenthal, University of Medicine and Dentistry of New Jersey, Newark, in a related article on medwireNews. There was an increase in goals-of-care discussions from 2 percent at baseline to 39 percent post-intervention. Designated DNR status rose from 52 percent at baseline to 81 percent. The mean time from DNR order to death increased by two to four days, which provided patients with the opportunity to say goodbye to their loved ones and come to terms with their death, the study concludes. Plan now to take your first doctoral level course during AACN’s 2014 National Teaching Institute & Teaching Exposition in Denver. The Advanced Leadership course will be offered as a 3-day intensive preconference. This is a required course for Case Western Reserve’s world renowned cohortbased DNP degree program. Case Western Reserve University’s Frances Payne Bolton School of Nursing created the nation’s first practice doctorate in nursing. We’ll innovate again in this new collaboration with AACN. Experience Your First Doctoral Course at NTI 2014 Learn more at NTI 2013 Booth 1901 in Boston. Or write to DNP program director Donna Dowling at 12 MARCH 2013

Table of Contents for the Digital Edition of Bold Voices - March 2013

Front/Digital Edition Viewing Guide
Another Angle
Design an NTI Just for You
New Guidelines Set Practice Framework for Tele-ICU NursingPractice
New Methods Increase Speed of Sepsis Diagnosis
High Blood Pressure Can Injure the Brain of Young Adults
Recurrent Hypoglycemia May Not Impair Long-Term Development of Preterm Infants
Superstorm Sandy Hospital Evacuation Decisions Questioned
New STEMI Guidelines Focus on Symptom Recognition, Ease of Use
Early Communication About Resuscitation Improves EOL Quality
Vote Now for AACN Board, Nominating Committee Members
Simple Measures Reduce Pneumonia
Fresh Blood in the ICU
Meeting Veterans’ Healthcare Needs
In Our Journals
Checklists May Reduce Venous Thromboembolism
Certification Capsules
Chapter Leadership Workshop @NTI 2013
Wear Your NTI Pride on May 20
Dare To

Bold Voices - March 2013