Emergency clinician perceptions of end-of-life care in Irish emergency departments: a cross-sectional survey.

Background: Patients with end-of-life care (EoLC) needs present to the emergency departments (ED) frequently and at times, it can be difficult to provide a high standard of care. Within the Irish setting, there is limited literature on the provision of EoLC in EDs and this study, therefore, aimed to evaluate the perceptions of emergency medicine (EM) clinicians regarding the provision of EoLC in EDs in Ireland.

Methods: The End-of-Life Care in Emergency Department Study was a cross-sectional electronic survey study of EM doctors working across 23 of the 29 EDs in the Ireland.

Gynaecologic oncology referrals to specialist palliative care in a tertiary referral centre: population, characteristics and outcomes.

Background: The early integration of a specialist palliative care team is demonstrated to have numerous benefits for patients. These extend beyond end-of-life care to include reducing depressive symptoms, improving quality of life and reducing unnecessary interventions.

Aims: This study aims to characterise the patient population referred to the specialist palliative care service with a diagnosis of gynaecological cancer.

Comparison of a novel methadone rotation method with other commonly used methods.

Objectives: To compare a novel method of methadone rotation used in a specialist palliative care inpatient unit (SPCU) in Cork, Ireland, with rapid titration methods using Perth and Brisbane Protocols as well as the Edmonton method of methadone rotation.

Methods: A retrospective chart review was performed in March-June 2022. All patients who completed rotation to methadone during 2018-2019 in the SPCU were included.

Primary data on symptom burden and quality of life among elderly patients at risk of dying during unplanned admissions to an NHS hospital: a cohort study using EuroQoL and the integrated palliative care outcome scale.

Background: Older people account heavily for palliative care needs at the population level and are growing in number as the population ages. There is relatively little high-quality data on symptom burden and quality of life, since these data are not routinely collected, and this group are under-recruited in primary research. It is unclear which measurement tools are best suited to capture burdens and experience.

Dealing with digital paralysis: Surviving a cyberattack in a National Cancer center.

Introduction: Cyberattacks represent a growing threat for healthcare delivery globally. We assess the impact and implications of a cyberattack on a cancer center in Ireland.

Methods: On May 14th 2021 (day 0) Cork University Hospital (CUH) Cancer Center was involved in the first national healthcare ransomware attack in Ireland.

Heart failure symptom burden in outpatient cardiology: observational cohort study.

Objectives: To assess the self-reported symptom burden in patients with a diagnosis of heart failure attending an outpatient cardiology clinic through the utilisation of validated patient-reported outcome measures.

Methods: Eligible patients were invited to partake in this observational cohort study. Participant demographics and comorbidities were recorded, followed by participants recording their symptoms using the Integrated Palliative care Outcome Scale (IPOS) and Brief Pain Inventory (BPI) outcome measure tools.

An Overview of the Impact of the Covid-19 Pandemic on the Provision of Palliative Care.

The Sars-Cov-2 pandemic had an immeasurable impact on the provision of palliative care in Ireland, and continues to do so. Patients and families were affected by stringent infectious disease measures. Healthcare professionals were also impacted, with recent research demonstrating the psychological impact that the pandemic had on some of those working in palliative care during the pandemic.

Impact of the COVID-19 pandemic on cancer care in Ireland - Perspectives from a COVID-19 and Cancer Working Group.

Upon the COVID-19 pandemic onset in Ireland, cancer service disruptions occurred due to prioritisation of COVID-19 related care, redeployment of staff, initial pausing of screening, diagnostic, medical and surgical oncology procedures, staff shortages due to COVID-19 infection and impacts on the physical and mental health of cancer healthcare workers. This was coupled with reluctance among people with symptoms suspicious for cancer to attend for clinical evaluation, due to concerns of contracting the virus. This was further compounded by a cyber-attack on national health service IT systems on May 14th 2021.

Exploring the Use of an Electronic Competency Assessment Document Using iPad Minis to Assess Clinical Practice Competency in a Preregistration Nursing Program: A Cross-sectional Feasibility Study.

The aim of this study was to explore the feasibility of using iPad minis as a method of completing competency assessment in clinical practice. Digital technology helps to revolutionize all aspects of our lives. The use of digital technologies in clinical practice can facilitate a move toward a more flexible learning environment and enable students to adapt in a rapidly changing, interconnected world.

Video consultations in community palliative care - patient satisfaction: mixed methods study.

Objectives: Community palliative care (CPC) has traditionally been delivered face to face in the home or in the outpatient clinic setting. The COVID-19 pandemic necessitated the introduction of video consultation (VC) as a modality of CPC service provision. Evidence supports the feasibility of VC in CPC.

Immune Checkpoint Inhibitors and Palliative Care at the End of Life: An Irish Multicentre Retrospective Study.

Immune checkpoint inhibitors (ICIs) have less toxicity than standard chemotherapy and are now standard of care for many patients with advanced cancer. A manageable side effect profile and potential for durable responses may lead to aggressive care of the palliative patient. We sought to evaluate palliative care input and ICI use at the end of life at two Irish cancer centres.

Care of the adult cancer patient at the end of life: ESMO Clinical Practice Guidelines.

• This ESMO Clinical Practice Guideline provides key recommendations for end-of-life care for patients with advanced cancer. • It details care that is focused on comfort, quality of life and approaching death of patients with advanced cancer. • All recommendations were compiled by a multidisciplinary group of experts.

Assessing the impact of COVID-19 on healthcare staff at a combined elderly care and specialist palliative care facility: A cross-sectional study.

Background: In the pre-COVID-19 era, healthcare professionals experienced stress and burnout. The international literature confirms that COVID-19 placed significant additional burdens on healthcare workers.

Aim: To describe and characterise the magnitude and variety of ways in which the COVID-19 pandemic affected the personal, social and professional lives of healthcare workers representing several multidisciplinary specialties in a fully-integrated palliative and elderly care service.

Patients' spirituality perspectives at the end of life: a qualitative evidence synthesis.

Background: Understanding patient perceptions of their spiritual needs when approaching the end of life is essential to support the delivery of patient-centred care.

Aim: To conduct a qualitative evidence synthesis on spirituality and spiritual care needs at the end of life in all healthcare settings from the patients' perspective.

Design: Studies were included where they were primary qualitative studies exploring spirituality in patients with a life expectancy of 12 months or less in any setting.

Exploring the Interface of Oncology and Palliative Care in Ireland.

Aims To explore the integration and delivery of oncology led referrals to palliative care (PC) by examining physician attitudes and referral practices. Methods An online survey was circulated to oncologists and PC physicians in Ireland. Results The study (N = 100) comprised sixty-nine oncologists (69%) and thirty-one PC physicians (31%).

Exploring patients' interest in complementary therapies in a specialist palliative care unit.

Background:: The use of complementary therapy has become increasingly integrated into specialist palliative care units (SPCUs).

Objective:: To evaluate patients' interest in and experience of complementary therapies during their inpatient stay in a SPCU.

Method:: All 179 patients admitted to the SPCU over a 3-month period were assessed on admission.

Pathophysiology and management of opioid-induced constipation: European expert consensus statement.

Background: Opioid-induced bowel dysfunction is a complication of opioid therapy, in which constipation is the most common and problematic symptom. However, it is frequently under-recognised and thus effective management is often not instituted despite a number of treatment options.

Objective: The central objective of this study is to provide a summary of the pathophysiology and clinical evaluation of opioid-induced constipation and to provide a pragmatic management algorithm for day-to-day clinical practice.

Cross-sectional examination of extrapyramidal side effects in a specialist palliative care inpatient unit.

Objectives: Extrapyramidal side effects (EPSEs) are serious potentially reversible side effects of antipsychotic and other medications that can cause distress for patients. A core principle of palliative care involves optimising quality of life. If side effects of medications are burdensome, it is imperative that we address this issue.

Emergency anaphylaxis protocols: A cross-sectional analysis of general practice surgeries and pharmacies in both the urban and rural setting in Ireland.

Background: The incidence of anaphylaxis appears to be increasing worldwide with cases in the community outnumbering those in the hospital setting. General practice (GP) surgeries and pharmacies, based in the community, are often the first point of contact for many patients suffering from anaphylaxis.

Objectives: To determine if studied GP surgeries and pharmacies have an anaphylaxis protocol on site and have access to an anaphylaxis kit; to explore GP's and pharmacists' personal experiences with management of anaphylaxis.

Invitation to grief in the family context.

Grief is a family affair, yet it is commonly viewed as an individual phenomenon. As an international, interdisciplinary team, we explore grief within a family context across theoretical, research, practice, and educational domains. Families are complex and working with this complexity is challenging but necessary for a holistic view of grief.

Oral Prolonged-Release Oxycodone/Naloxone for Managing Pain and Opioid-Induced Constipation: A Review of the Evidence.

Background: Opioids provide effective relief from moderate-to-severe pain and should be prescribed as part of a multifaceted approach to pain management when other treatments have failed. Fixed-dose oxycodone/naloxone prolonged-release tablets (OXN PR) were designed to address the opioid class effect of opioid-induced constipation (OIC) by combining the analgesic efficacy of oxycodone with the opioid receptor antagonist, naloxone, which has negligible systemic availability when administered orally. This formulation has abuse-deterrent properties, since systemic exposure to naloxone by parenteral administration would antagonize the euphoric effects of oxycodone.

Transdermal buprenorphine and fentanyl patches in cancer pain: a network systematic review.

Treatment of cancer pain is generally based on the three-step World Health Organization (WHO) pain relief ladder, which utilizes a sequential approach with drugs of increasing potency. Goals of pain management include optimization of analgesia, optimization of activities of daily living, minimization of adverse effects, and avoidance of aberrant drug taking. In addition, it is recommended that analgesic regimens are individualized and simplified to help ensure patient compliance and should provide the least invasive, easiest, and safest route of opioid administration to ensure adequate analgesia.