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www.ahrq.gov/sites/default/files/2024-10/feudtner-report.pdf
January 01, 2024 - First do no harm--to err is human. Eff Clin Pract
2000;3(6):294-6.
7. … Ethics and
communication: does students' comfort addressing: ethical issues vary
by specialty team? … Palliative care for
infants, children, and adolescents : a practical handbook. … Palliative care for infants, children, and adolescents : a
practical handbook. … Pediatric palliative, end-of-life, and bereavement care.
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psnet.ahrq.gov/web-mm/forgotten-radiographic-read
June 07, 2016 - The patient was transitioned to comfort care and died that evening. … humans will occasionally make errors, while modifying our systems of care to protect patients from harm … clinical settings, from acute myocardial infarction and stroke to routine cosmetic surgery ( 8 ) to palliative … Creating safeguards and redundancies in provision of care can help protect patients from harm. … Silent night: retrospective database study assessing possibility of "weekend effect" in palliative care
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psnet.ahrq.gov/node/50754/psn-pdf
December 18, 2019 - the end, they believed the third option from above best respected the patient’s wishes and minimized
harm … multiple opportunities for improvement, which will
be discussed in the next section; thankfully, no harm … In this case, no harm was done by the
somewhat utilitarian decision to suspend the patient’s partial … But there was certainly the potential to harm a
patient in this situation by not respecting her wishes … Journal of palliative medicine. 2015
May 1;18(5):457-60. [Full free text]
3.
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psnet.ahrq.gov/sites/default/files/2019-12/spotlight_code_status_dec_2019_powerpoint.pdf
January 01, 2019 - In the end, they
believed the third option best respected her wishes and minimized harm, so her code … status without their or surrogate’s knowledge
is problematic
– Ethically fraught area
– Potential to harm … a patient if an unexpected complication occurs
• In this case, there was no harm, but patient preferences … Journal of palliative medicine. 2015 May 1;18(5):457-60. … BMC palliative care. 2018 Dec;17(1):114.
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psnet.ahrq.gov/web-mm/wrongful-resuscitation
October 12, 2012 - Increasingly, nursing homes are utilizing "Do Not Hospitalize (DNH) Unless for Comfort" orders in frail … Smith, your goal is to focus on your comfort, not interventions that would prolong your life." … However, if that is not possible, care should focus on comfort even if it shortens life. … Such a focus on comfort may lead to a decision to forego further hospitalizations. … Such clarification may result in the use of a "Do Not Hospitalize Unless for Comfort" order.
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psnet.ahrq.gov/web-mm/do-you-want-everything-done-clarifying-code-status
March 27, 2024 - the end, they believed the third option from above best respected the patient’s wishes and minimized harm … multiple opportunities for improvement, which will be discussed in the next section; thankfully, no harm … In this case, no harm was done by the somewhat utilitarian decision to suspend the patient’s partial … But there was certainly the potential to harm a patient in this situation by not respecting her wishes … BMC palliative care. 2018 Dec;17(1):114. [Free full text] POLST Paradigm on the POLST Website.
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psnet.ahrq.gov/web-mm/febrile-neutropenia-and-almost-fatal-medication-error
February 01, 2012 - and incorrect dosing in patients with decreased renal and hepatic function can lead to significant harm … PDQ Supportive and Palliative Care Editorial Board. Bethesda, MD: National Cancer Institute. … NCCN clinical practice guidelines in oncology: palliative care.
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psnet.ahrq.gov/web-mm/engaging-seriously-ill-older-patients-advance-care-planning
December 22, 2018 - Concerned about the possible harm the patient could experience, the intern and his supervisor engaged … care that was strongly associated with their preferences, and the majority preferred limited care or comfort … See More About The Topic
Ambulatory Care
Physicians
Primary Care
Geriatrics
Palliative
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/cancer-end-of-life-indicators-symposium_research.pdf
April 01, 2010 - Pain assessment tools: is the content
appropriate for use in palliative care? … National Consensus Project for Quality
Palliative Care. … Palliative care quality measurement project. … Quality indicators for palliative and end-of-
life care in vulnerable elders. … Improving comfort and communication in
the ICU: a practical new tool for palliative
care performance
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psnet.ahrq.gov/web-mm/empty-bag
June 01, 2018 - patient's family chose not to put her through surgery, and she was placed on the hospice service for comfort … needs, hospitals can choose IV infusion equipment that enhances safety.( 9 ) In another example, many palliative … Unreliable numbers: error and harm induced by bad design can be reduced by better design. … Falling Through the Crack (in the Bedrails)
May 1, 2016
Measuring harm … More
See More About The Topic
Hospitals
Health Care Providers
Engineers
Palliative
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/pf-engagement-slides.html
July 01, 2023 - Suggest comfort measures.
Provide support and suggestions for the partner. … Communicating about episodes of harm to patients. In: Leonard M, ed. … Palliative Care Perspectives. 1st ed. New York: Oxford University Press; 2003.
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/advanced-care-decision-aids_technical-brief.pdf
July 01, 2014 - use of
life support technology
Plan for site of
death, preference for
sedation versus
physical comfort … whether participants felt their surrogates better understood their wishes,
that the tools provided comfort … *African Americans differed from whites in preferences for receiving comfort care versus life sustaining … If comfort care is the choice that is consistent with the informed
consumer’s values and wishes, then … Journal of
Palliative Medicine. 2011;Feb;14(2):169-77.
PMID: 21254815.
36.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/engagement.pptx
May 01, 2017 - of a Doula3
A doula accompanies a woman in labor to—
Provide emotional and physical support
Suggest comfort … Communicating about episodes of harm to patients. In: Leonard M, ed. … Palliative Care Perspectives. 1st ed. New York: Oxford University Press; 2003.
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psnet.ahrq.gov/node/49789/psn-pdf
April 01, 2017 - Concerned about the possible harm the patient could experience, the intern and his supervisor engaged … care that was strongly associated with their
preferences, and the majority preferred limited care or comfort
-
effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-265-radiation-bone-disease-disposition-comments.pdf
August 29, 2023 - Page 2 of the introduction
introduces the concern that
“…there is substantial variation
in how palliative … What is the
effectiveness and what are the
harms of EBRT in the palliative
treatment of bone metastases
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www.ahrq.gov/hai/tools/mvp/modules/technical/4es-early-mobility-slides.html
February 01, 2017 - Explain preventable harm to staff.
Share stories about patients.
Develop a business case. … Patient on comfort/palliative care measures.
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datatools.ahrq.gov/action-alliance/
June 30, 2024 - patients and the healthcare workforce, with a vision of safe care everywhere and zero preventable harm … Working together, NAA members catalyze change by applying known harm reduction strategies and sharing … Recognizing that healthcare is not safe until it is safe for all, the NAA works to address harm across … Patients with a directive for comfort care or palliative care within 6 hours of presentation of severe … Patients with a directive for comfort care or palliative care within 6 hours of presentation of septic
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/4es-early-mobility-slides.pptx
January 01, 2017 - Explain preventable harm to staff
Share stories about patients
Develop a business case
Include executive … Not applicable – patient at highest possible level of mobility
Bed rest orders
Patient on comfort/palliative
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www.ahrq.gov/teamstepps-program/curriculum/team/tools/index.html
July 01, 2023 - should also be noted that for patients with limited English proficiency, who are at higher risk of harm … patient’s broader care needs related to mobility, nutrition, independent living, and, potentially, comfort … or palliative care.
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www.ahrq.gov/hai/cauti-tools/guides/implguide-pt3.html
October 01, 2015 - Hospice/comfort/palliative care —This is an acceptable indication for catheter use in end-of-life care … when it facilitates meeting patient and family goals in a dying patient or helps with patient comfort … An exception would be for patients who are receiving end-of-life or palliative care and in whom a catheter … Patient request for external catheter to manage urinary incontinence while hospitalized
Improvement in comfort