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Measuring Quality of Dying in End‐Stage Renal Disease
Author(s) -
Spital Aaron,
Cohen Lewis M.,
Germain Michael J.
Publication year - 2004
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.0894-0959.2004.17348.x
Subject(s) - medicine , palliative care , pride , quality (philosophy) , intensive care medicine , benchmarking , end stage renal disease , workgroup , dialysis , nursing , disease , management , computer network , philosophy , epistemology , political science , computer science , law , economics
Palliative medicine operates under the presumption that it is possible to improve the quality of a patient's death. Nephrology has justifiably taken pride in its reliance on internal benchmarking and the use of quality targets to shape clinical practice innovations, and this article discusses the efforts that are being made to measure end‐of‐life care of dialysis patients. A tool called the Dialysis Quality of Dying Apgar is described that examines five domains (pain, nonpain symptoms, advance care planning, peacefulness, and time) which are scored and then summed. A recent interdisciplinary workgroup of renal professionals has commissioned a series of focus groups that have attempted to ascertain patient and family values and preferences for the management of terminal situations. The results are summarized, and they should hopefully form a basis for the development of additional research and clinical measurement tools.