Educational agendas for interdisciplinary end-of-life curricula.
The importance of an interdisciplinary end-of-life curricula for the intensive care unit is now recognized. Educational agendas for interdisciplinary end-of-life curricula are being developed across the United States. However, the limited database on palliative care education precludes evidence-based recommendations. Through a case-based approach, the need for an interdisciplinary team is explored, including the definition of an interdisciplinary team and the step-wise incorporation of specific members, such as physicians, nurses, social workers, and the chaplain, as patient care evolves. Core competencies for end-of-life care are enumerated including the approaches to end-of-life care, ethical and legal constraints, symptom management, specific end-of-life syndromes/palliative crises, and development of communication skills for trusting relationships. Finally, four phases of ICU management of curative and comfort care are proposed: phase I, focus on checklist for transfer; phase II, focus on life-saving treatments; phase III, focus on the "whole" patient; and phase IV, focus on palliative care.
Department of Medicine, Oregon Health Sciences University and Veterans Affairs Medical Center, Portland, Oregon 97201-3098, USA.
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Mularski
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Bascom
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Osborne
D002983:Clinical Competence / Q000592:standards; D003142:Communication; D003422:Critical Care / Q000458:organization & administration / Q000523:psychology; D003479:Curriculum; D016208:Databases, Factual; D004995:Ethics, Professional; D019317:Evidence-Based Medicine; D005190:Family / Q000523:psychology; D017408:Guidelines as Topic; D006282:Health Personnel / Q000193:education*; D006801:Humans; D020380:Needs Assessment; D009937:Organizational Objectives; D010347:Patient Care Planning; D010348:Patient Care Team; D018802:Patient-Centered Care; D016730:Program Development; D013663:Teaching / Q000379:methods; D013727:Terminal Care / Q000458:organization & administration / Q000523:psychology; D014481:United States