Critical Care Topics
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Some Hospice Medical Aid in Dying Policies Require Staff to Leave Room
Ethicists recommend hospices consider revising policies so nurses can support their patients clinically and emotionally at a critical moment.
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Many Seriously Ill Older Adults Lack Documented Goals-of-Care Discussions
Benign nudges may advance those discussions. These conversations do not need to be lengthy. A few short inquiries asked by a respectful, attentive provider is all that is needed to help many patients share concerns and preferences for care.
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The Complicated Ethics of Medical Aid in Dying
Some patients and staff alike do not know what the process is, which can lead to misconceptions. Others might not want to ask about it, while some might object on moral grounds. Researchers are working on better education.
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Adjuvant Systemic Corticosteroid Therapy in Hospitalized Patients with Community-Acquired Pneumonia
In this meta-analysis, all-cause mortality, ICU admission, and incidence of adverse events were similar in patients who received corticosteroids compared to standard care. However, the corticosteroid therapy group recorded a lower incidence of progression to mechanical ventilation.
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Practice Alert Provides Critical Care Nurses Safety Tips for Prone Positioning
The technique that became well known during the COVID-19 pandemic remains a standard tactic for managing acute respiratory distress syndrome.
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Intervention for Critically Ill Patients Lowered In-Hospital Mortality Rates
Researchers believe their work could be a starting place for emergency clinicians to think about novel care delivery models for seriously ill patients.
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Early Communication Can Establish Goals of Care Boundaries
When clinicians initiate the conversation, there can be a better understanding about the wishes of seriously ill patients.
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Is Death Imminent? Conflicts Occur if Clinicians Do Not Make It Clear
Poor communication on prognosis prevents the family from making decisions based on the true situation. If surrogates do not realize death is imminent, they cannot plan for hospice care or contact family members to be there for the patient’s last moments.
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Ethical End-of-Life Care for Homeless Patients
Clinicians should acknowledge their own potential bias and avoid using language in the medical record that is stigmatizing. Also, they can request an ethics consult before making any decision to not provide care for a patient experiencing homelessness.
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Advance Care Planning Can Lower Odds of Aggressive End-of-Life Treatment
Advance care planning was associated with significantly lower odds of indicators of aggressive end-of-life care (i.e., hospital death, hospital admissions, intensive care, delayed hospice referrals, and chemotherapy). Cancer patients who engaged in advance care planning were 50% more likely to complete Do Not Resuscitate orders compared to cancer patients without an advance directive.