scholarly journals Managing end-of-life pain using a rectal medication administration device

2015 ◽  
Author(s):  
Yen Kim
Keyword(s):  
End Of Life ◽  
Medication Administration ◽  
Rectal Medication

School Nurses’ Experience With Administration of Rectal Diazepam Gel for Seizures

2007 ◽  
Vol 23 (3) ◽  
pp. 166-169 ◽  
Author(s):  
Christine O’Dell ◽  
Kathryn O’Hara
Keyword(s):  
Early Intervention ◽  
School District ◽  
School Setting ◽  
Medication Administration ◽  
School Nurses ◽  
Scope Of Practice ◽  
Rectal Diazepam ◽  
State Practice ◽  
Acute Seizure ◽  
Rectal Medication

The purpose of this study was to determine school nurses’ knowledge of state and school district policies, their experience regarding the administration of rectal diazepam gel in the school, and the perceived benefits and barriers of providing this treatment. Four hundred nineteen nurses responded to a survey conducted during the National Association of School Nurses Annual Meeting. Seventy-one (18%) nurses surveyed had administered rectal diazepam gel in a school setting, while 54 (13%) nurses reported that either their state practice act or school district prohibited them from giving rectal medications in the school. Medication administration benefits, such as early intervention for treatment of acute seizure emergencies, were noted. Barriers were also identified, with lack of privacy as the most frequently listed. Scope of practice as it pertains to administering medication in the school and the extent to which delegation of duties can be used in the situation of administering rectal medication in a seizure emergency remain issues for school nurses.

Inpatient care at the end of life: A closer look.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 43-43
Author(s):  
Alison Wiesenthal ◽  
Anabella Lucca Bianchi ◽  
Vinnidhy Dave ◽  
Robert Sidlow ◽  
Susan Seo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Palliative Medicine ◽  
Retrospective Chart Review ◽  
Medication Administration ◽  
Careful Consideration ◽  
Cancer Center ◽  
Inpatient Setting ◽  
Do Not Resuscitate

43 Background: Goals of care discussions in the inpatient setting often focus on the limitation of cardiopulmonary resuscitation and Allow Natural Death (AND) directives; decisions regarding medication administration and further diagnostic studies may be missing from the conversation. De-prescribing at the end of life (EOL) can be emotionally complex for patients and their families, though data is emerging that quality of life may be enhanced by limiting unnecessary medications. Our study assessed care in the last 3 days of life for cancer patients who die in hospital. Methods: Retrospective chart review of all inpatient deaths at a tertiary cancer center between 12/1/2012 and 11/30/2014. The frequency of lab draws, administered medications, and subspecialty consultations during the last 3 days of life were recorded. Results: Of the 1,311 inpatient deaths during the two year study period, 44% had Palliative Medicine consultation. On average, Palliative Medicine was consulted 6.5 days before death, with a median consultation time of 3 days before death. Do not resuscitate (DNR) orders were active for over 80% of patients at the time of death, with an average DNR enacted 4.6 days prior to death (range 0-60 days). Medications most often provided at the end of life were analgesics, fluids, and antibiotics (See Table 1). Consistent with Quality Oncology Practice Initiative (QOPI) Measures, <1% of patients were treated with chemotherapy in the last 3 days of life. Most patients (85%) had laboratory tests in their final 3 days of life, with a mean of 21 orders per patient. Conclusions: Non-palliative services are often provided to hospitalized patients at the end of life. Careful consideration must be given to the potential benefits and harms of medical interventions at the EOL to improve quality of life for the dying patient. Further research is needed to understand the drivers behind the care provided at EOL to inform educational tools for clinicians. [Table: see text]

Emergency Management of Seizures in the School Setting

2007 ◽  
Vol 23 (3) ◽  
pp. 158-165 ◽  
Author(s):  
Christine O’Dell ◽  
Kathryn O’Hara ◽  
Sarah Kiel ◽  
Kathleen McCullough
Keyword(s):  
Emergency Treatment ◽  
Treatment Plan ◽  
School Setting ◽  
School Personnel ◽  
Critical Issue ◽  
Medication Administration ◽  
School Nurses ◽  
Emergency Department Visits ◽  
Rectal Medication ◽  
Treatment Plans

Effective seizure management in the school setting is a critical issue for students with seizures, as well as their parents, classmates, and school personnel. The unpredictable nature of seizures and the potential outcomes of experiencing a seizure in school are sources of anxiety for students with seizures. The ability to respond appropriately to a seizure is of concern to parents and school personnel. Implementation of a seizure emergency treatment plan empowers school personnel to quickly treat the child. Diazepam rectal gel is commonly used in seizure emergency treatment plans. It is safe and effective in terminating seizures and reduces the time to treatment and the need for emergency department visits when used in the school setting, and can be administered by medical and delegated to trained nonmedical personnel. School nurses should be aware of the laws and professional recommendations that pertain to rectal medication administration in schools for optimal emergency seizure management.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

End-of-Life Issues for People Who Use AAC

2005 ◽  
Vol 14 (3) ◽  
pp. 15-19 ◽  
Author(s):  
Melanie Fried-Oken ◽  
Lisa Bardach
Keyword(s):  
End Of Life ◽  
Life Issues ◽  
End Of Life Issues

Dysphagia in Hospice Care: The Roles of Social Work and Speech-Language Pathologists

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray
Keyword(s):  
Social Work ◽  
End Of Life ◽  
Case Studies ◽  
End Of Life Care ◽  
Hospice Care ◽  
Patient Communication ◽  
Life Care ◽  
Speech Language Pathologists ◽  
Four Levels

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.

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