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Palliative Care in Critical Care, An Issue of Critical Care Nursing Clinics of North America, Volume 27-3 (Hardcover)
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Palliative Care in Critical Care, An Issue of Critical Care Nursing Clinics of North America, Volume 27-3 (Hardcover)
Series: The Clinics: Nursing
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Intensive care units (ICUs) provide comprehensive, advanced care to
patients with serious or life-threatening conditions and
consequently, a significant amount of end-of-life care (EOLC).
Indeed, approximately 20% of deaths in the U.S. are associated with
an ICU stay, and nearly half of U.S. patients who die in hospitals
experience an ICU stay during the last 3 days of life. Despite the
commonality of the ICU experience, ICU patients typically suffer
from a range of distressing symptoms such as pain, fatigue,
anxiety, and dyspnea, causing families significant distress on
their behalf. Thus, there is a growing imperative for better
provision of palliative care (PC) in the ICU, which may prevent and
relieve suffering for patients with life threatening illnesses.
Effective palliative care is accomplished through aggressive
symptom management, communication about the patient and family's
physical, psychosocial and spiritual concerns, and aligning
treatments with each patient's goals, values, and preferences. PC
is also patient-centered and uses a multidisciplinary, team-based
approach that can be provided in conjunction with other
life-sustaining treatments, or as a primary treatment approach.
Failure to align treatment goals with individual and family
preferences can create distress for patients, families, and
providers. If implemented appropriately, palliative care may
significantly reduce the health care costs associated with
intensive hospital care, and help patients avoid the common,
non-person centered treatment that is wasteful, distressing, and
potentially harmful. Due to the success of many PC programs,
administrators, providers, and accrediting bodies are beginning to
understand that palliative care in the ICU is vital to optimal
patient outcomes.
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