Kadriye KAHVECİ

Palliative care and intensive care integration

With developments in technology and in healthcare policies in Turkey, both the quality and number of applications of care have increased in recent years in intensive care units. At the same time, rates of hospital mortality have increased due to the rise in the elderly population, changes in family structure, increased urban population and easier access to health facilities. Intensive care units are the places where deaths and functional and cognitive disorders are most frequently seen. Current models where intensive care and palliative care are integrated are seen as an important component of comprehensive care for patients with critical disease and who are receiving aggressive intensive care treatment. The goal in intensive care and palliative care integration is to promote better quality, lower cost, patient and family satisfaction. The aim of this review was to highlight the importance and necessity of palliative care applications in intensive care units. It can be concluded that an increase in palliative care training, legal regulations made related to end-of-life patient care and the implementation of palliative care in intensive care unit would provide more effective use of intensive care units

PDF

___

1. http://www.un.org/en/development/desa/population/publications/pdf/ ageing/WPA2015_Report.pdf.
2. Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;374(9696):1196-208.
3. Dinçer M. Kardiyak risk faktörlerinin hastanede yatiş süresine etkileri üzerine bir uygulama. İktisadi ve İdari Bilimler Fakültesi Dergisi. 2016;18(1):1-26.
4. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS med. 2006;3(11):e442.
5. Jukic M, Saric L, Prkic I, Puljak L. Medical futility treatment in intensive care units. Acta Med Acad. 2016;45(2):135-44.
6. Villa G, De Gaudio AR, Falsini S, Lanini I, Curtis JR. Development of END-of-Life ScorING-System to identify critically ill patients after initial critical care who are highly likely to die: a pilot study. Minerva Anestesiol. 2015;81(12):1318-28.
7. Nelson JE, Bassett R, Boss RD, Brasel KJ, Campbell ML, Cortez TB, Curtis JR, Lustbader DR, Mulkerin C, Puntillo KA, Ray DE, Weissman D. Models for structuring a clinical initiative to enhance palliative care in the intensive care unit: a report from the IPAL-ICU Project (Improving Palliative Care in the ICU). Crit Care Med. 2010;38(9):1765-72
8. Aslakson R, Cheng J, Vollenweider D, Galusca D, Smith TJ, Pronovost PJ. Evidence-based palliative care in the intensive care unit: a systematic review of interventions. J Palliat Med. 2014;17(2):219-35.
9. Aslakson RA, Curtis JR, Nelson JE. The changing role of palliative care in the ICU. Crit Care Med. 2014;42(11):2418-28.
10. Organization WH. Cancer pain relief and palliative care: report of a WHO expert committee [meeting held in Geneva from 3 to 10 July 1989]. 1990.
11. WHO. Global Atlas of Palliative Care at the End of Life. http://www.thewhpca.org/resources/global-atlas-on-end-of-life-care].
12. Guidelines.NCPQPC. http://www.nationalconsensusproject.org/guideline. pdf 2009 access date 10.03.2017
13. http://www.tkhk.gov.tr/8231_yeni-palyatif-baki.
14. Ventura Mde M. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Sao Paulo medical journal = Revista paulista de medicina. 2016;134(1):93-4.
15. Lustbader D, Mudra M, Romano C, Lukoski E, Chang A, Mittelberger J, Scherr T, Cooper D. The Impact of a Home-Based Palliative Care Program in an Accountable Care Organization. J Palliat Med. 2017;20(1):23-8.
16. Kynoch K, Chang A, Coyer F, McArdle A. The effectiveness of interventions to meet family needs of critically ill patients in an adult intensive care unit: a systematic review update. JBI Database System Rev Implement Rep. 2016;14(3):181-234.
17. Bakanlığı TS. Sağlık İstatistiği Yıllığı 2014. Sağlık Araştırmaları Genel Müdürlüğü Ankara Sentez Matbaacılık ve Yayıncılık. 2015.
18. SÜLEKLİ HE KA. T.C. Sağlık Bakanlığı Türkiye Kamu Hastaneleri KurumuYoğun Bakım Üniteleri Araştırması 2015 [cited 2017 10.03.2017].
19. Myburgh J, Abillama F, Chiumello D, Dobb G, Jacobe S, Kleinpell R, Koh Y, Martin C, Michalsen A, Pelosi P, Torra LB, Vincent JL, Yeager S, Zimmerman J. End-of-life care in the intensive care unit: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2016;34:125-30.
20. Kahveci K. Gokcinar D. Knowledge about palliative care in the families of patients. Acta Med Medit. 2014;30:1369-73
21. Baker M, Luce J, Bosslet GT. Integration of Palliative Care Services in the Intensive Care Unit: A Roadmap for Overcoming Barriers. Clinics in chest medicine. 2015;36(3):441-8.
22. Edwards JD, Voigt LP, Nelson JE. Ten key points about ICU palliative care. Intensive Care Med. 2017;43(1):83-5.
23. Nelson JE, Hope AA. Integration of palliative care in chronic critical illness management. Respiratory care. 2012;57(6):1004-12; discussion 12-3.
24. Khandelwal N, Kross EK, Engelberg RA, Coe NB, Long AC, Curtis JR. Estimating the effect of palliative care interventions and advance care planning on ICU utilization: a systematic review. Crit Care Med. 2015;43(5):1102-11.
25. Mun E, Ceria-Ulep C, Umbarger L, Nakatsuka C. Trend of Decreased Length of Stay in the Intensive Care Unit (ICU) and in the Hospital with Palliative Care Integration into the ICU. The Permanente journal. 2016;20(4):56-61.
26. Clarke EB, Curtis JR, Luce JM, Levy M, Danis M, Nelson J, Solomon MZ. Quality indicators for end-of-life care in the intensive care unit. Crit Care Med. 2003;31(9):2255-62.
27. Mularski RA, Curtis JR, Billings JA, Burt R, Byock I, Fuhrman C, Mosenthal AC, Medina J, Ray DE, Rubenfeld GD, Schneiderman LJ, Treece PD, Truog RD, Levy MM. Proposed quality measures for palliative care in the critically ill: a consensus from the Robert Wood Johnson Foundation Critical Care Workgroup. Crit Care Med. 2006;34(11 Suppl):S404-11.
28. Nelson JE, Puntillo KA, Pronovost PJ, Walker AS, McAdam JL, Ilaoa D, Penrod J. In their own words: patients and families define high-quality palliative care in the intensive care unit. Crit Care Med. 2010;38(3):808-18.
29. Curtis JR, Treece PD, Nielsen EL, Downey L, Shannon SE, Braungardt T, Owens D, Steinberg KP, Engelberg RA. Integrating palliative and critical care: evaluation of a quality-improvement intervention. Am J Respir Crit Care Med. 2008;178(3):269-75.
30. Frontera JA, Curtis JR, Nelson JE, Campbell M, Gabriel M, Mosenthal AC, Mulkerin C, Puntillo KA, Ray DE, Bassett R, Boss RD, Lustbader DR, Brasel KJ, Weiss SP, Weissman DE. Integrating Palliative Care Into the Care of Neurocritically Ill Patients: A Report From the Improving Palliative Care in the ICU Project Advisory Board and the Center to Advance Palliative Care. Crit Care Med. 2015;43(9):1964-77.
31. Mosenthal AC, Weissman DE, Curtis JR, Hays RM, Lustbader DR, Mulkerin C, Puntillo KA, Ray DE, Bassett R, Boss RD, Brasel KJ, Campbell M, Nelson J. Integrating palliative care in the surgical and trauma intensive care unit: a report from the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care. Crit Care Med. 2012;40(4):1199-206.
32. Truog RD, Campbell ML, Curtis JR, Haas CE, Luce JM, Rubenfeld GD, Rushton CH, Kaufman DC. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine. Crit Care Med. 2008;36(3):953-63.
33. Creutzfeldt CJ, Engelberg RA, Healey L, Cheever CS, Becker KJ, Holloway RG, Curtis JR. Palliative Care Needs in the Neuro-ICU. Crit Care Med. 2015;43(8):1677-84.
34. Kahveci K, Dincer M, Doger C, Yarici AK. Traumatic brain injury and palliative care: a retrospective analysis of 49 patients receiving palliative care during 2013-2016 in Turkey. Neural Regen Res. 2017;12(1):77-83.
35. (ELNEC) E-o-LNEC, SHEET F,) U-d. http://www.aacn.nche.edu/elnec/FactSheet.pdf.
36. Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med.
2012;40(2):618-24.Hua MS, Li G, Blinderman CD, Wunsch H. Estimates of the need for palliative care consultation across united states intensive care units using a trigger-based model. Am J Respir Crit Care Med. 2014;189(4):428-36.
37. Kiyota A, Bell CL, Masaki K, Fischberg DJ. What's the Plan? Needing Assistance with Plan of Care Is Associated with In-Hospital Death for ICU Patients Referred for Palliative Care Consultation. Hawaii J Med Public Health. 2016;75(8):235-41.
38. Norton SA, Hogan LA, Holloway RG, Temkin-Greener H, Buckley MJ, Quill TE. Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients. Crit Care Med. 2007;35(6):1530-5.
39. Wysham NG, Hochman MJ, Wolf SP, Cox CE, Kamal AH. Performance of Consultative Palliative Care Model in Achieving Quality Metrics in the ICU. J Pain Symptom Manage. 2016;52(6):873-7.
40. Campbell ML, Guzman JA. A proactive approach to improve end-oflife care in a medical intensive care unit for patients with terminal dementia. Crit Care Med. 2004;32(9):1839-43.
41. Bradley C, Weaver J, Brasel K. Addressing access to palliative care services in the surgical intensive care unit. Surgery. 2010;147(6):871- 7.
42. Quill TE, Abernethy AP. Generalist plus specialist palliative care-- creating a more sustainable model. N Engl J Med. 2013;368(13):1173-5.
43. Goepp JG, Meykler S, Mooney NE, Lyon C, Raso R, Julliard K. Provider insights about palliative care barriers and facilitators: results of a rapid ethnographic assessment. Am J Hosp Palliat Care. 2008;25(4):309-14.
44. Hughes MT, Smith TJ. The growth of palliative care in the United States. Annu Rev Public Health. 2014;35:459-75.
45. Campbell ML, Guzman JA. Impact of a proactive approach to improve end-of-life care in a medical ICU. Chest. 2003;123(1):266- 71.
46. Adolph MD, Frier KA, Stawicki SP, Gerlach AT, Papadimos TJ. Palliative critical care in the intensive care unit: A 2011 perspective. Int J Crit Illn Inj Sci. 2011;1(2):147-53.
47. Aldridge MD, Hasselaar J, Garralda E, van der Eerden M, Stevenson D, McKendrick K, Centeno C, Meier DE. Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliat Med. 2016;30(3):224-39.
48. Gay EB, Weiss SP, Nelson JE. Integrating palliative care with intensive care for critically ill patients with lung cancer. Ann Intensive Care. 2012;2(1):3.
49. O'Mahony S, McHenry J, Blank AE, Snow D, Eti Karakas S, Santoro G, Selwyn P, Kvetan V. Preliminary report of the integration of a palliative care team into an intensive care unit. Palliat Med. 2010;24(2):154-65.
50. Nelson JE, Angus DC, Weissfeld LA, Puntillo KA, Danis M, Deal D, Levy MM, Cook DJ. End-of-life care for the critically ill: A national intensive care unit survey. Crit Care Med. 2006;34(10):2547-53.
51. Nelson JE. Identifying and overcoming the barriers to high-quality palliative care in the intensive care unit. Crit Care Med. 2006;34(11 Suppl):S324-31.
52. Grudzen CR, Richardson LD, Major-Monfried H, Kandarian B, Ortiz JM, Morrison RS. Hospital administrators' views on barriers and opportunities to delivering palliative care in the emergency department. Ann Emerg Med. 2013;61(6):654-60