Evidence map›Paper›PMID 29549515›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2018

Multidrug-resistant bacterial microorganisms (MDRO) in end-of-life care: development of recommendations for hospitalized patients using a mixed-methods approach.

Maria Heckel, Stephanie Stiel, Franziska A Herbst, Johanna M Tiedtke, Alexander Sturm, Thomas Adelhardt, Christian Bogdan, Cornel Sieber, Oliver Schöffski, Frieder R Lang and 1 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Maria HeckelDepartment of Palliative Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany. maria.heckel@uk-erlangen.de.ORCID http://orcid.org/0000-0001-6212-2562
Stephanie StielInstitute for General Practice, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
Franziska A HerbstInstitute for General Practice, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
Johanna M TiedtkeInstitute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstraße 62, 90408, Nürnberg, Germany.
Alexander SturmDepartment of General Internal and Geriatric Medicine, Krankenhaus Barmherzige Brüder (Hospital of the Order of St. John of God Regensburg), Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Prüfeningerstraße 86, 93049, Regensburg, Germany.
Thomas AdelhardtDivision of Health Management, School of Business and Economics, Institute of Management (IFM) Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Lange Gasse 20, 90403, Nürnberg, Germany.
Christian BogdanInstitute of Clinical Microbiology, Immunology, and Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Wasserturmstraße 3-5, 91054, Erlangen, Germany.
Cornel SieberDepartment of General Internal and Geriatric Medicine, Krankenhaus Barmherzige Brüder (Hospital of the Order of St. John of God Regensburg), Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Prüfeningerstraße 86, 93049, Regensburg, Germany.
Oliver SchöffskiDivision of Health Management, School of Business and Economics, Institute of Management (IFM) Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Lange Gasse 20, 90403, Nürnberg, Germany.
Frieder R LangInstitute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Kobergerstraße 62, 90408, Nürnberg, Germany.
Christoph OstgatheDepartment of Palliative Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany.

Funding

German Federal Ministry of Education and Research (BMBF) 01GY1314
6 · The paper itself

Abstract

purposePalliative care professionals are frequently confronted with patients colonized or infected with MDRO. One major challenge is how to balance necessary isolation measures and social inclusion as one of the main principles of palliative and end-of-life care. To date, MDRO-specific policies and protocols vary widely between institutions.

aimprovide empirical recommendations on how to deal with hospitalized MDRO patients in end-of-life care.

methodsRecommendations were developed based on (i) initial results of face-to-face interviews and focus groups, (ii) impartial experts' comments and consensus on the draft via online survey and (iii) a face-to-face meeting with consortium members to finalize recommendations. Findings of 158 interviews and six focus groups (39 participants) with patients, family caregivers, staff members and institutional stakeholders contributed to the recommendations. The assessments of 17 experts were considered.

resultsIn total, 21 recommendations were approved. The recommended strategy in dealing with MDRO at the end of life allows case-based application of protection and isolation measures. MDRO diagnostics and therapy involve screening at admission. The recommendations suggest consideration of required accommodation facilities, provided material as well as staff and time resources. The recommendations further highlight the importance of providing for strategies enabling the patient's social inclusion and provision of verbal and written information about MDRO for patients and family caregivers, transparent medical documentation, and staff member training.

conclusionThe recommendations summarize the perspectives of individuals and groups affected by MDRO at the end of life and provide practical guidance for clinical routine. Further dissemination and implementation requirements are discussed and should contain the evaluation of the knowledge, views, worries, and anxieties of the target groups.

Indexed as

Drug Resistance, Multiple, BacterialHospice CareHumansMethicillin-Resistant Staphylococcus aureusPalliative CareTerminal CareDrug resistanceEmpirical researchMethicillin-resistant Staphylococcus aureusMultiplePalliative carePractice guidelineTerminal care

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.