Triad Vi

Mirarchi, Ferdinando L.; Doshi, Ankur; Zerkle, Samuel W.; Cooney, Timothy E.

doi:10.1097/pts.0000000000000165

Cited by 46 publications

(29 citation statements)

References 30 publications

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“…The study was conducted at a single institution and results may not be generalizable to other oncology care settings. The response rate was less than 50% and although our response rate was higher than that seen in other physician surveys,[39–41] it cannot be assumed to represent the entire institution. Additionally, this was an anonymous survey and as such we are unable to assess potential differences between responders and non-responders.…”

Section: Discussioncontrasting

confidence: 64%

Oncology healthcare providers’ knowledge, attitudes, and practice behaviors regarding LGBT health

Shetty

Sánchez

Lancaster

et al. 2016

Patient Education and Counseling

121

107

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Objective There are limited data on lesbian, gay, bisexual, and transgender (LGBT) health and healthcare experiences. An important part of healthcare experiences are interactions with the provider. This study assessed knowledge, attitudes, and practice behaviors of oncology providers regarding LGBT health. Methods A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey was divided into five sections: demographics, knowledge, attitudes, practice behaviors, and open comments. Results 108 providers participated in the survey (28% response rate). Less than 50% answered the knowledge questions. 94% stated they were comfortable treating this population. 26% actively inquired about a patient’s sexual orientation when taking a history and 28% felt they were well informed on the health needs of this population. 36% felt the need for mandatory education on LGBT cultural competency at the institution. Results from the open comments section identified key themes such as the need for increased oncology provider education and a misconception that inquiring about a patient’s sexual orientation/gender identity wasn’t necessary. Conclusion This study revealed knowledge gaps about LGBT health risks in the majority of providers surveyed. Cultural competency training may aid oncology providers to understand the need to know a patient’s gender identity and sexual orientation. Practice Implications Health care providers who incorporate the routine collection of gender identity and sexual orientation (SOGI) in their patient history taking may improve patient care. While identifying as LGBT does not in itself increase risk for adverse health outcomes, this population tends to have increased risk behaviors. Providers who are aware of LGBT status of their patients may offer education, counseling and referrals for reduction of risk behaviors.

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Section: Discussioncontrasting

confidence: 64%

Oncology healthcare providers’ knowledge, attitudes, and practice behaviors regarding LGBT health

Shetty

Sánchez

Lancaster

et al. 2016

Patient Education and Counseling

121

107

View full text Add to dashboard Cite

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“…7 ,8 Thus, these studies yield 2 concerning conclusions. First, by allowing potentially confusing combinations of orders, POLST could cause patients to receive care that is either more or less aggressive than patients preferred when the documents were completed.…”

Section: Clarity Of Interpretationmentioning

confidence: 75%

“…In the recent TRIAD VI and VII studies, 7, 8 emergency physicians (n = 223) and out-of-hospital personnel(n = 1069) were asked to interpret sample POLST forms with different combinations of orders. Study participants were then asked to state how they would treat a patient who presented with each form.…”

Section: Clarity Of Interpretationmentioning

confidence: 99%

“…8 All other order combinations of resuscitation and medical intervention orders resulted in inconsistent interpretations. For example, only 616 (58%) of 1059 out-of-hospital personnel 8 and 97 (51%) of 191 emergency physicians 7 stated that they would refrain from resuscitating a patient found in cardiac arrest with a POLST specifying DNR and full medical treatment.…”

Section: Clarity Of Interpretationmentioning

confidence: 99%

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The Problems With Physician Orders for Life-Sustaining Treatment

Moore

Rubin

Halpern

2016

JAMA

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“…Tools like the POLST help outpatient providers initiate conversations about specific goals of care in advance of critical illness, but such tools have not been specifically developed and validated for initiation in the acute setting [16,17]. Prior data suggest that emergency providers have difficulty interpreting that may lead to care that is not concordant with patient wishes [18]. …”

Section: Discussionmentioning

confidence: 99%

Impact of early do-not-attempt-resuscitation orders on procedures and outcomes of severe sepsis

Sarkari

Perman

Ginde

2016

Journal of Critical Care

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Purpose Do-not-attempt-resuscitation (DNAR) orders are common in severe sepsis, but the impact on clinical care is not known. Our primary objective was to determine the impact of early DNAR orders on in-hospital mortality and performance of key interventional procedures among severe sepsis hospitalizations. Our secondary objective was to further investigate what patient characteristics within the sepsis DNAR population affected outcomes. Methods Using the 2010–2011 California State Inpatient Dataset, we analyzed hospitalizations for adults admitted through the emergency department with severe sepsis. Our primary predictor was a DNAR order, and our outcomes were in-hospital mortality and performance of interventional procedures. Results Visits with early DNAR orders accounted for 20.3% of severe sepsis hospitalizations. An early DNAR order was a strong, independent predictor of higher in-hospital mortality (odds ratio [OR], 4.03; 95% confidence interval, 3.88–4.19) and lower performance of critical procedures: central venous line (OR, 0.70), mechanical ventilation (OR, 0.80), hemodialysis (OR, 0.61), and major operative procedure (OR, 0.46). Among those with early DNAR orders, older age and rural location were the strongest predictors for a lack of interventional procedures. Conclusion Although DNAR orders are not synonymous with “do not treat,” they may unintentionally limit aggressive treatment for severe sepsis patients, especially in older adults.

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Triad Vi

Cited by 46 publications

References 30 publications

Oncology healthcare providers’ knowledge, attitudes, and practice behaviors regarding LGBT health

Oncology healthcare providers’ knowledge, attitudes, and practice behaviors regarding LGBT health

The Problems With Physician Orders for Life-Sustaining Treatment

Impact of early do-not-attempt-resuscitation orders on procedures and outcomes of severe sepsis

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