Paice Judith A, Muir J Cameron, Shott Susan
Northwestern University Medical School, Division of Hematology-Oncology, Northwestern Memorial Hospital, Palliative Care and Home Hospice Program, Chicago, Illinois, USA.
Am J Hosp Palliat Care. 2004 Jan-Feb;21(1):19-27. doi: 10.1177/104990910402100107.
There is growing awareness that pain and other symptoms are often poorly managed at the end of life. The purpose of this quality improvement project was to compare the quality of care provided to a convenience sample of 195 patients who died during a six-month period, using a retrospective chart review. Quality was defined by symptom documentation, use of diagnostic and therapeutic procedures in the final 48 hours of life, and determination of advance directives. Daily and total charges incurred by these patients were also captured. Symptom distress was common, and diagnostic and therapeutic procedures were widespread. These data suggest areas for improvement in clinical practice, in palliative care units, and in all settings where end-of-life care is provided. Also, the data can guide future research into the quality of care provided to dying persons.
人们越来越意识到，在生命末期，疼痛和其他症状往往得不到妥善处理。本质量改进项目的目的是通过回顾性病历审查，比较为195名在六个月内死亡的便利样本患者提供的护理质量。质量的定义包括症状记录、生命最后48小时内诊断和治疗程序的使用以及预先指示的确定。还记录了这些患者的每日费用和总费用。症状困扰很常见，诊断和治疗程序也很普遍。这些数据表明了临床实践、姑息治疗病房以及所有提供临终护理的场所中需要改进的领域。此外，这些数据可以为未来关于为临终者提供护理质量的研究提供指导。
