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首页> 外文期刊>The American journal of hospice and palliative care >You need not make the journey alone: overcoming impediments to providing palliative care in a public urban teaching hospital.
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You need not make the journey alone: overcoming impediments to providing palliative care in a public urban teaching hospital.

机译：您不必独自旅行：克服在公立城市教学医院提供姑息治疗的障碍。

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摘要

The majority of dying patients continue to receive care in acute, tertiary settings. This has generated the development of hospital-based palliative care (HBPC). The Symptom Management and Palliative Care Program (SMPCP) at LAC+USC Medical Center provides HBPC. The SMPCP operates as an interdisciplinary consultative service, assessing inpatients, and documenting recommendations for primary physicians. Over a 28-month period the SMPCP provided clinical recommendations, education, and research for patients, family members, and hospital staff Demographic, clinical, psychosocial, financial, and outcome information was collected on 265 patients. The SMPCP documented the attainment of defined quality end-points, including pain control within 24 hours, a Do Not Resuscitate (DNR) discussion with patient and family within 72 hours, and control of nausea and vomiting within 24 hours. Team members also documented impediments to implementing recommendations and the success of interventions to overcome impediments. Results indicated that the SMPCP achieved a high rate of quality end-point attainment when impediments were not present. The most significant impediments resulted from behaviors by primary physicians. The SMPCP's ability to overcome barrier behaviors improved the rate of end-point attainment, confirming the importance of palliative care at the end of life.
机译：大多数垂死的患者继续在急性，三级环境中接受护理。这推动了基于医院的姑息治疗（HBPC）的发展。 LAC + USC医疗中心的症状管理和姑息治疗计划（SMPCP）提供了HBPC。 SMPCP作为一个跨学科的咨询服务，对住院病人进行评估，并为主要医生提供建议文件。在28个月的时间内，SMPCP为患者，家庭成员和医院工作人员提供了临床建议，教育和研究，收集了265例患者的人口统计学，临床，社会心理，财务和结果信息。 SMPCP记录了达到规定的质量终点的情况，包括在24小时内控制疼痛，在72小时内与患者和家人进行“不要复苏”（DNR）讨论以及在24小时内控制恶心和呕吐。团队成员还记录了实施建议的障碍以及克服障碍的成功干预措施。结果表明，当没有障碍时，SMPCP可以达到很高的质量终点指标。最主要的障碍来自主治医师的行为。 SMPCP克服障碍行为的能力提高了终点达标率，证实了临终时姑息治疗的重要性。

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