Abstract：
CONTEXT:Accurate documentation of inpatient code status discussions (CSDs) is important because of frequent patient care handoffs. OBJECTIVES:To examine the quality of inpatient CSD documentation and compare documentation quality across physician services. METHODS:This was a retrospective study of patients hospitalized between January 1 and June 30, 2011 with a new or canceled do-not-resuscitate (DNR) order at least 24 hours after hospital admission. We developed a chart abstraction tool to assess the documentation of five quality elements: 1) who the DNR discussion was held with, 2) patient goals/values, 3) prognosis, 4) treatment options and resuscitation outcomes, and 5) health care power of attorney (HCPOA). RESULTS:We identified 379 patients, of whom 235 (62%) had a note documenting a CSD. After excluding patients lacking a note from their primary service, 227 remained for analysis. Sixty-three percent of notes contained documentation of who the discussion was held with. Patient goals/values were documented in 43%, discussion of prognosis in 14%, treatment options and resuscitation outcomes in 40%, and HCPOA in 29%. Hospitalists were more likely than residents to document who the discussion was held with (P < 0.001) and patient goals/values (P < 0.001), whereas internal medicine residents were more likely to document HCPOA (P = 0.04). The mean number of elements documented for hospitalists was 2.40, followed by internal medicine residents at 2.07, and non-internal medicine trainees at 1.30 (P < 0.001). CONCLUSION:Documentation quality of inpatient CSDs was poor. Our findings highlight the need to improve the quality of resident and attending CSD documentation.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Thurston A,Wayne DB,Feinglass J,Sharma RKdoi
10.1016/j.jpainsymman.2013.11.014subject
Has Abstractpub_date
2014-10-01 00:00:00pages
632-8issue
4eissn
0885-3924issn
1873-6513pii
S0885-3924(14)00136-5journal_volume
48pub_type
杂志文章abstract：:The hospice model of care of the dying patient is regarded as a model of excellence; however, outcomes of this care have been poorly demonstrated. Integrated Care Pathways (ICPs) provide a method of recording and measuring outcomes of care. The ICP document replaces all previous documentation and is a multiprofessiona...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(00)00240-2
更新日期：2001-01-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
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abstract：CONTEXT:Many surveys have evaluated patient-related barriers to pain management. OBJECTIVES:To explore associations between a preference for opioids and general attitudes toward drugs, the experience and information received as a bereaved family, and beliefs regarding a good death. METHODS:A cross-sectional survey, p...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2014.04.015
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
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abstract：CONTEXT:Despite the recognized distressing symptom of fatigue in children with cancer, little information is available to assist in the selection of an instrument to be used to measure fatigue. OBJECTIVES:The objectives of this study were to 1) describe the instruments that have been used to measure cancer-related fat...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2012.02.010
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abstract：CONTEXT:Observer-based sedation scales have been used to provide a measurable estimate of the comfort of nonalert patients in palliative sedation. However, their usefulness and appropriateness in this setting has not been demonstrated. OBJECTIVES:To study the reliability and validity of observer-based sedation scales ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.11.010
更新日期：2012-11-01 00:00:00
abstract：:Dexamethasone is likely to play a role in the etiology of hiccups in patients receiving cisplatin-based regimens. Two hundred seventy-seven patients received three doses of ondansetron 8mg intravenously (IV) at 4hour intervals plus dexamethasone 20mg IV from the start of chemotherapy, followed by dexamethasone 5mg IV ...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/j.jpainsymman.2005.08.008
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2012.05.014
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2008.09.006
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
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更新日期：1997-09-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2014.03.006
更新日期：2014-12-01 00:00:00
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,多中心研究,评审
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journal_title：Journal of pain and symptom management
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doi：10.1016/j.jpainsymman.2008.10.007
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abstract：:Visual analogue scales (VAS) and verbal rating scales (VRS) are widely used to assess pain. This paper presents a secondary analysis of a subsection of data collected as part of an evaluation of an intervention to improve nighttime pain. The aims were to describe the relationship between the VAS and VRS; to compare ch...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2005.05.014
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2012.07.010
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：
更新日期：1998-02-01 00:00:00
abstract：CONTEXT:Pain has been reported as the second most commonly reported symptom in people living with HIV/AIDS. In South Africa, there are more than five million people living with HIV/AIDS. Approximately, two million belong to the Xhosa cultural group. The prevalence of pain in amaXhosa living with HIV/AIDS was unknown at...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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更新日期：2016-01-01 00:00:00
abstract：:Pain is a multidimensional phenomenon with physical, psychological, and social components and is a significant problem for 50% of hemodialysis (HD) patients. Failure to treat pain adequately may lead to disruption in many aspects of life. This study examines the relationship between moderate to severe chronic pain and...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2005.05.013
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