Medicine and Health Sciences Commons^™

Symptom Burden And Healthcare Utilization In Pulmonary Arterial Hypertension, Catherina Anne Madani Phd

Dissertations

Background: Pulmonary arterial hypertension (PAH) is a rapidly progressive disease. There is currently no cure; thus treatment is aimed at prolonging survival, improving functional status (FS), and symptom mitigation. Symptom burden (SB) can impact quality of life (QOL), and lead to increased healthcare utilization. Palliative care (PC) has been associated with higher QOL, decreased depression, aggressive care, and mortality. The Institute of Medicine's (IOM) recent report supports earlier integration of PC for people living with serious illness. Detection of patients at high risk for heavy SB may help to identify patients who could benefit from earlier integration of PC into …

White Paper: Building A Continuum Of End Of Life Care In Whatcom County: Inspire Culture Change, Marie Eaton

Northwest Life Passages Coalition Documents

This Task Force was charged with identifying best practices related to cultural change regarding end of life issues. However, we believe that there is no single best practice at the community level. Our community and cultural responses related to living with serious illness and facing our own mortality or experiencing the death of loved ones continue to evolve. Our generation is the first that that has cared for parents or other loved ones in a health care system that has the potential for keeping people alive too long – and these experiences are changing our feelings about what choices we …

Investigating Barriers To Access And Delivery Of Palliative Care For Persons With Dementia In London, Ontario, Emily M. Hill

Electronic Thesis and Dissertation Repository

Dementia is a syndrome that is progressive, degenerative and terminal. The palliative care philosophy aims to maximize quality of life for the dying individual and has been recognized in the literature as being both beneficial and under-used in persons dying with dementia. The purpose of this study was to investigate the experiences of staff delivering palliative care to individuals with dementia to determine how care was delivered, to learn which assessment tools were used, and whether policies were affected the delivery of palliative care. Twenty-two staff participants were interviewed. Data were interpreted using phenomenological methodology. Findings yielded three themes: confusion, …

Palliative Care And Hospice Community Education, Mary Castang

Regis University Student Publications (comprehensive collection)

Executive Summary Palliative Care and Hospice Community Education Problem In the researcher's home hospice practice, a need for community education regarding Palliative Care and Hospice is recognized. Patients and family members need information about End of Life (EOL) care options prior to the urgency of a crisis. According to Szirony, Oopko, Masiulaniec and Binder (2011) many patients and family members learn of hospice and palliative care services only after admission into a program. The decision to sign in to a program reflects their perception of there being no other choice rather than understanding the options and benefits (Szirony, et al, …

Integrating Palliative Care Content Into A New Undergraduate Nursing Curriculum: The University Of Notre Dame, Australia – Sydney Experience, John M. Ramjan, Catherine M. Costa, Louise D. Hickman, Margot Kearns, Jane L. Phillips

Catherine M Costa

Background: The majority of society's deaths occur in a health care environment. Regardless of whether a death occurs in acute care, hospice, residential aged care or community settings, nurses are the health professionals that will spend the largest proportion of time with the patient who has a terminal condition and their families. As few nurses have specialist palliative care qualifications it is essential that nursing education prepares graduates to achieve the core capabilities required for the delivery of best evidenced based palliative care. This reality makes the integration of palliative care content into the undergraduate nursing curricula an important priority. …

Program - Palliative Care Summer Institute: A Call To Action, Palliative Care Institute

Palliative Care Institute

No abstract provided.

Influence Of A Palliative Care Protocol On Nurses' Perceived Barriers To Palliative Care And Moral Distress, Christina Cavinder

Evidence-Based Practice Project Reports

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported …

Applying The Principle Of Double Effect, Andria E. Quirindongo

CedarEthics: A Journal of Critical Thinking in Bioethics

When ethical conflicts arise in clinical cases, physicians may need specific guidelines to help justify the decisions they make for the best interest of their patients. One such guideline is the principle of double effect (PDE), employed in terminally ill patients. Palliative care physicians look to the PDE when a single action for a terminal patient has two known effects: a desired and intended result and an unintended, yet foreseeable one.

Palliative Care Nurses' Recognition And Assessment Of Delirium Symptoms: A Qualitative Study Using Critical Incident Technique, Annmarie Hosie, Meera Agar, Elizabeth Lobb, Patricia M. Davidson, Jane Phillips

Health Sciences Papers and Journal Articles

Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses’ integral patient care role, little is known about palliative care nurses’ capacity to recognise, assess and respond to patients’ delirium symptoms. Objective: To explore the experiences, views and practices of inpatient palliative care nurses in delirium recognition and assessment. Settings and participants: 30 nurses from nine Australian specialist palliative care inpatient services. Design and methods: Critical incident technique (CIT) guided a series of semi-structured interviews. Prior to interviews participants were given a vignette of a palliative care inpatient with an unrecognised hypoactive delirium, to prompt …

Nursing Student Experiences Of Death And Dying During A Palliative Care Clinical Placement: Teaching And Learning Implications, Olivia Gallagher, Rosemary Saunders, Karen Tambree, Selma Alliex, Leanne Monterosso, Y Naglazas

Nursing Conference Papers

The Building Capacity in Palliative Care Clinical Training project commenced in 2012 and is providing a dedicated palliative care clinical learning experience for nursing and medical students as part of preparation for palliative care practice in future workplaces. Many students fear death on a clinical placement. This paper reports on a pilot study as part the broader project evaluation that examined nursing students’ experiences of death and how the project driven teaching and learning supported students’ learning experiences.

Identifying The Barriers And Enablers To Pallative Care Nurses' Recognition And Assessment Of Delirium Symptoms: A Qualitative Study, Annmarie Hosie, M Agar, Elizabeth A. Lobb, P M. Davidson, Jane Phillips

Nursing Papers and Journal Articles

Context: Delirium is under-recognised by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses’ delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients’ delirium outcomes.

Objective: To identify nurses’ perceptions of the barriers and enablers to recognising and assessing delirium symptoms in palliative care inpatient settings.

Methods: A series of semi-structured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants’ recall of …

Utilizing Watson's Theory Of Caring To Develop A Palliative Care Proposal For Olmsted Medical Center, Tammie Johnson

Theses and Graduate Projects

Palliative care is aimed at alleviating the suffering of patients with serious or chronic illnesses. Literature examined to determine the needs of seriously or chronically ill patients and their farnilies found patients to have physical, psychosocial, and spiritual needs while coping with their illness. In addition, patients' family needed support in physical care of their loved ones, as well as information and psychosocial needs for themselves. The purpose of this project is to develop a proposal for an inpatient palliative care program for Olmsted Medical Center's (OMC's) consideration, Watson's Theory of Caring was utilized in the development of a palliative …

Empowering Home Care Nurses To Begin End-Of-Life Conversations, Angela Oujiri

Theses and Graduate Projects

In the United States, some people find the discussion of death and dying a difficult topic to discuss. This difficulty has often delayed conversations about goals and wishes until very late in the healthcare journey. Delays come with a significant cost to both patients and the entire healthcare system. Palliative care is a special type of care meant to provide an extra layer of support to patients and families who are living with serious illness; however, the practice of such care encounters has many challenges for patients, families, physicians, and nurses. Home care nurses are instrumental in the delivery of …

Do Palliative Care Health Professionals Settle For Low Level Evidence?, R J. Chan, Jane Phillips, D C. Currow

Nursing Papers and Journal Articles

No abstract provided.

End-Of-Life Delirium: Issues Regarding Recognition, Optimal Management And The Role Of Sedation In The Dying Phase., S H. Bush, M M. Leonard, M Agar, J A. Spiller, Annmarie Hosie, D Wright, D J. Meagher, D C. Currow, E Bruera, P G. Lawlor

Nursing Papers and Journal Articles

CONTEXT:

In end-of-life care, delirium is often not recognized and poses unique management challenges, especially in the case of refractory delirium in the terminal phase.

OBJECTIVES:

To review: delirium in the terminal phase context, specifically in relation to recognition issues; the decision-making processes and management strategies regarding its reversibility; the potential refractoriness of delirium to symptomatic treatment; and the role of sedation in refractory delirium.

METHODS:

We combined multidisciplinary input from delirium researchers and knowledge users at an international delirium study planning meeting and relevant electronic database literature searches (Ovid Medline, Embase, PsycINFO and CINAHL) to inform this narrative review. …