Medicine and Health Sciences Commons^™

A Good Life: Palliative Care In The World Of Dementia, Nicola Farmer

Journal of Interdisciplinary Graduate Research

Objective: The World Health Organization (2019) reports that dementia is the seventh leading cause of death with an estimated 50 million people worldwide with this disease. In the United States out of one and a half million Medicare patients on hospice in 2016, only 18% had dementia (The National Hospice and Palliative Care Organization, 2017). McAteer and Wellbery (2013) identified that while referrals to services seem to be on the rise, many are not made until the patient is close to death in the last weeks of an illness. The purpose of this project was to review the literature to …

Palliative Care And Improving Quality Of Life With End Stage Renal Disease: An Integrative Review, Natoya Bender

Doctoral Dissertations and Projects

End-stage renal disease is a rising health care problem effecting greater than 10% of the US population. there are 700,000 patients in dialysis in the U.S who are characterized by multiple comorbidities and increasing, distressing symptom burden. The need for palliative care for patient with end-stage renal disease is becoming standard of care due to their complex medical needs and high symptom burden. The aim of this integrative review investigated the incorporation of palliative care will improve the quality-of-life of patients with end-stage renal disease once introduced in their care. While palliative care provides an ideal opportunity to assess the …

Spiritual Care: The Overlooked Need In End-Of-Life Care, Michael Howard Vrmeer

Doctor of Nursing Practice Scholarly Projects

Background: A number of studies have validated the use of the FICA tool to evaluate a patient’s spirituality. FICA has been helpful in many palliative care settings to screen for spiritual problems that influence the patient's overall health. Aim: The project was a quality improvement initiative with the purpose of implementing the FICA tool as part of the admission assessment to increase chaplain referrals for inpatient palliative care services. Methods: The staff received an in-service on using the FICA questions on admission, and a prompt to complete the screen was placed at each work station in the project setting. Results: …

Examining The Course Of Transitions From Hospital To Home-Based Palliative Care: A Mixed Methods Study, Stephanie Saunders, Marianne Weiss, Chris Meaney, Tieghan Killackey, Jaymie Varenbut, Emily Lovrics, Natalie Ernecoff, Amy T. Hsu, Maya Stern, Ramona Mahtani, Kirsten Wentlandt, Sarina R. Isenberg

College of Nursing Faculty Research and Publications

Background:

Hospital-to-home transitions in palliative care are fraught with challenges. To assess transitions researchers have used patient reported outcome measures and qualitative data to give unique insights into a phenomenon. Few measures examine care setting transitions in palliative care, yet domains identified in other populations are likely relevant for patients receiving palliative care.

Aim:

Gain insight into how patients experience three domains, discharge readiness, transition quality, and discharge-coping, during hospital-to-home transitions.

Design:

Longitudinal, convergent parallel mixed methods study design with two data collection visits: in-hospital before and 3–4 weeks after discharge. Participants completed scales assessing discharge readiness, transition quality, and …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

An Interprofessional Approach To Holistic End-Of-Life., Andrew Aschbacher

Doctor of Nursing Practice Papers

Purpose: The goal of this Doctor of Nursing Practice (DNP) project was to develop and evaluate an evidence-based clinical practice guideline (EBP) for an interprofessional approach across four end-of-life care domains (1) ethnocentric spiritual wellbeing, (2) mental wellbeing, (3) symptom management, and (4) value-based goals of care. Design and Methods: The Iowa Model for the Development of Evidence-Based Practice guided the development of the practice guideline. A multi-phase literature review was conducted to establish and grade the best evidence. A two-phase evaluation plan was developed. The University of Louisville Institutional Review Board approved the project. Results: In evaluation phase one, …

Nur 4050 Family Centered End Of Life Care Across The Life Span Syllabus, Linda Bradley

Open Educational Resources

This course explores the nurses’ involvement in family centered end-of-life care. Principles of hospice and palliative care are used and discussed along with the myriad of needs facing individuals and their families at this time of life. The burden and distress of those facing life’s end and the ability of nurses to offer support for the physical, psychological, social, and spiritual needs of clients and their families are presented.

Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is little known about the part end-of-life care plays in patient care. This paper examines the role of end-of-life care in the care of a dying patient and consists of findings from a service-learning project with Circle of Life hospice. To be able to effectively care for those in the end stages of life, healthcare professionals must turn away from the curative aspects of medicine, to treating symptoms and improving quality of whatever life remains for the patient. In order to normalize EOL Care and consequently make it more accessible, we must educate our healthcare practitioners regarding the benefits …

The Value Of Family Support At The End Of Life, Hannah Butler

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is little research about the role of the family when a patient is dying. This paper examines the role of family support in end-of-life care. This paper consists of the findings from a service learning project with Circle of Life hospice. Patients with family support are more likely to have a DNR, chaplain visit, die at home, and other indicators of quality care. Patients with family support are more likely to receive higher quality care.

Improving Family Nurse Practitioners’ Knowledge Of Palliative Care Resources, Michelle L. Bond

Theses and Graduate Projects

The shift in healthcare indicates Americans are living longer with progressive chronic illnesses subsequently reducing quality-of-life. Primary care providers have opportunities to assess the need for and implement palliative care to offer holistic symptom management to improve patient’s quality-of-life. The purpose of this scholarly project, guided by Jean Watson’s Theory of Human Caring, is to assess primary care providers knowledge and comfort regarding initiating palliative care while determining if additional education improves their familiarity. The objectives were to review current palliative care literature identifying barriers and inadequacies, determine evidence-based practice to develop an educational presentation and resources to improve communication, …

Clinicians' Delirium Treatment Practice, Practice Change, And Influences: A National Online Survey, Annmarie Hosie, Meera Agar, Gideon A. Caplan, Brian Draper, Stephen Hedger, Debra Rowett, Penny Tuffin, Seong Leang Cheah, Jane L. Phillips, Linda Brown, Manraaj Sidhu, David C. Currow

Nursing Papers and Journal Articles

Background: Recent studies cast doubt on the net effect of antipsychotics for delirium.

Aim: To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework.

Design: Australia-wide online survey of relevant clinicians.

Setting/participants: Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals’ organisations.

Results: Most of the sample (n=475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium …

Clinical Practice Guideline For Palliative Care Referral, Samantha Jones

Walden Dissertations and Doctoral Studies

Palliative care is a type of specialty care that focuses on the improvement of the quality of life and prevention of suffering of those with progressive serious illnesses by addressing the physical, emotional, and spiritual needs of patients and families. There are many misperceptions about palliative care by providers, patients, and their families. Inconsistent interventions and a lack of palliative care education for providers results in delayed palliative care involvement. Delayed involvement results in patients with unmet palliative care needs. The purpose of this project was to develop clinical practice guidelines to ensure appropriate care based on the best available …

End-Of-Life Nursing Consortium To Improve The Gap In Palliative Care, Emma Kroger

DNP Projects

Abstract

Objective: The purpose of this project is to implement a palliative care education intervention with a pre- and post-survey to assess knowledge, emotional preparedness, and confidence in undergraduate nursing students at the University of Kentucky.

Aim: The aim of this project is to address the gap in palliative care education by increasing professional knowledge, emotional preparedness, and confidence levels in regards to palliative care of future nurses at the University of Kentucky.

Background: The terms “hospice” and “palliative” are often used interchangeably in the healthcare setting. However, palliative care focuses on symptom management in all stages of acute, chronic, …

Sleep-Related Problems, Sleep-Related Distress, And Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care, Lisa C. Sievers

Theses and Dissertations

Palliative care patients may be at a higher risk for sleep-related problems and their negative effects compared to the general population, yet limited sleep research has been done with this population. The purpose of this dissertation was to determine prevalence rates for excessive sleepiness, insomnia, restless legs syndrome (RLS), and high risk for sleep apnea (HRSA); examine relationships between the aforementioned sleep-related problems, sleep-related distress (SD), and sleep-related functional status (SFS); and to determine which sleep-related problem measures along with age and gender predicted SD and SFS among a sample of adult palliative care inpatients. Secondary aims were to understand …

Clinical Staff Perceptions On The Quality Of End-Of-Life Care In An Australian Acute Private Hospital: A Cross-Sectional Survey, Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

Research outputs 2014 to 2021

Objective: To explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital. Methods: A descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses. Results: Overall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt …

Effectiveness Of Online Communication Skills Training For Cancer And Palliative Care Health Professionals: A Systematic Review, Melissa N. Berg, Irene Ngune, Penelope Schofield, Lisa Grech, Ilona Juraskova, Michelle Strasser, Zoe Butt, Georgia K.B Halkett

Nursing Papers and Journal Articles

Objective: To determine the reported effect of online communication skills training (CST) on health professional (HP) communication skills and patient care outcomes in cancer and palliative care.

Methods: Primary research published in English between January 2003 and April 2019 was identified in bibliographic databases including Medline, Embase and Proquest (Prospero: CRD42018088681). An integrated mixed-method approach included studies describing a CST intervention and its effect, for cancer or palliative care HPs, delivered online or blended with an online component. Included studies' outcomes were categorised then findings were stratified by an evaluation framework and synthesised in an effect direction plot. Risk of …

Intensive Care Unit Nurse: Could We Call A Palliative Care Consult? Intensive Care Unit Provider: It's Too Early. Palliative Care Integration In The Intensive Care Unit: The Struggle To Translate Evidence Into Practice, Natalie S. Mcandrew, Jill L. Guttormson, Sean Marks, Mary Rhodes, Jayshil Patel, Colleen Mccracken

College of Nursing Faculty Research and Publications

Despite evidence regarding the value of palliative care, there remains a translation-to-practice gap in the intensive care setting. The purpose of this article is to describe challenges and propose solutions to palliative care integration through the presentation and discussion of a critical care patient scenario. We also present recommendations for a collaborative palliative care practice framework that holds the potential to improve quality of life for patients and families. Collaborative palliative care is characterized by close working relationships with families, interprofessional intensive care unit healthcare teams, and palliative care specialists. The shortage of palliative care specialists has become a pressing …