Open Access. Powered by Scholars. Published by Universities.®
- Discipline
-
- Nursing (48)
- Social and Behavioral Sciences (18)
- Oncology (13)
- Geriatrics (12)
- Public Health (12)
-
- Medical Education (11)
- Mental and Social Health (11)
- Geriatric Nursing (10)
- Palliative Nursing (9)
- Arts and Humanities (8)
- Other Nursing (8)
- Primary Care (8)
- Alternative and Complementary Medicine (7)
- Critical Care Nursing (7)
- Education (7)
- Family Practice Nursing (7)
- Interprofessional Education (7)
- Psychology (7)
- Critical Care (6)
- Health Services Research (6)
- Health and Medical Administration (6)
- Medicine and Health (6)
- Public Health Education and Promotion (6)
- Sociology (6)
- Communication (5)
- Community Health and Preventive Medicine (5)
- Diseases (5)
- Institution
-
- University of Kentucky (8)
- University of San Diego (6)
- Grand Valley State University (5)
- The University of San Francisco (4)
- University of Central Florida (4)
-
- Western University (4)
- Himmelfarb Health Sciences Library, The George Washington University (3)
- Union College (3)
- University of St Augustine for Health Sciences (3)
- East Tennessee State University (2)
- Gardner-Webb University (2)
- Loma Linda University (2)
- Minnesota State University, Mankato (2)
- Pittsburg State University (2)
- Seattle Pacific University (2)
- The Texas Medical Center Library (2)
- The University of Akron (2)
- University of Missouri, St. Louis (2)
- Virginia Commonwealth University (2)
- Western Michigan University (2)
- Winona State University (2)
- Aga Khan University (1)
- California State University, Monterey Bay (1)
- California State University, San Bernardino (1)
- Dominican University of California (1)
- Eastern Illinois University (1)
- Eastern Kentucky University (1)
- Edith Cowan University (1)
- James Madison University (1)
- Lesley University (1)
- Keyword
-
- Palliative care (18)
- Hospice (10)
- Palliative (6)
- Palliative Care (6)
- Quality of life (6)
-
- Education (5)
- End of life (5)
- Cancer (4)
- Heart failure (4)
- Nursing (4)
- Death (3)
- End-of-life care (3)
- Hospice care (3)
- Intensive care (3)
- Oncology (3)
- Outcomes (3)
- Screening (3)
- Spirituality (3)
- Telehealth (3)
- Advance care planning (2)
- Advance directive (2)
- Caregivers (2)
- Criteria (2)
- Death and dying (2)
- Dementia (2)
- Deprescribing (2)
- Dying (2)
- End-of-life (2)
- Hope (2)
- Hospice Care (2)
- Publication Year
- Publication
-
- DNP Projects (6)
- Doctor of Nursing Practice Final Manuscripts (6)
- Doctor of Nursing Practice Projects (4)
- Doctoral Projects (4)
- Electronic Thesis and Dissertation Repository (4)
-
- Honors Undergraduate Theses (4)
- Dissertations (3)
- Honors Theses (3)
- All Graduate Theses, Dissertations, and Other Capstone Projects (2)
- Dissertations & Theses (Open Access) (2)
- Doctor of Nursing Practice (DNP) Projects (2)
- Doctor of Nursing Practice Scholarly Project (2)
- Electronic Theses and Dissertations (2)
- Honors Projects (2)
- Loma Linda University Electronic Theses, Dissertations & Projects (2)
- Masters Theses (2)
- Student Scholarly Projects (2)
- Theses and Dissertations (2)
- Williams Honors College, Honors Research Projects (2)
- Arts & Sciences Electronic Theses and Dissertations (1)
- Capstone Projects and Master's Theses (1)
- DNP Qualifying Manuscripts (1)
- Department of Family Therapy Dissertations and Applied Clinical Projects (1)
- Dissertations (1934 -) (1)
- Doctoral Dissertations (1)
- Doctors of Nursing Practice (DNP) Final Projects, 2020-current (1)
- Electronic Theses, Projects, and Dissertations (1)
- Evidence-Based Practice Project Reports (1)
- Expressive Therapies Capstone Theses (1)
- Graduate Theses, Dissertations, and Problem Reports (1)
Articles 1 - 30 of 84
Full-Text Articles in Palliative Care
Evidence-Based Practice For Terminal Extubation: A Guideline Development For Critical Care, Heather Marica
Evidence-Based Practice For Terminal Extubation: A Guideline Development For Critical Care, Heather Marica
Student Scholarly Projects
Practice Problem: In the critical care unit it was identified that providers utilized various practices in managing patients who were to be terminally extubated (TE). The variations in TE practice resulted in healthcare providers engaging in the TE process feeling unsure of the care they were providing and questioning if best practice measures were being implemented.
PICOT: The PICOT question guiding this project was: “In acute care adult patients who are to be TE (P), how does the development of an evidence-based TE guideline (I) compared to current TE practices (C) improve critical care healthcare workers perception and ability to …
Education For Primary Care Providers On Advance Care Planning: A Systematic Literature Review, Lindsey Ward
Education For Primary Care Providers On Advance Care Planning: A Systematic Literature Review, Lindsey Ward
DNP Qualifying Manuscripts
Background: Healthcare providers in primary care treat patients at various stages of life. As patients age, it becomes necessary for providers to support their older patients throughout the aging process and address patient care even into life’s end stages. Primary care providers (PCPs) are well-positioned to provide this support and can do so through incorporating end-of-life (EOL) conversations in practice. Such discussions are called advance care planning (ACP). Though PCPs can play a crucial role in their patients’ EOL care decisions, providers report their limited knowledge of ACP as a barrier to its application.Consequently, further education for providers on utilizing …
Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen
Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen
Student Scholarly Projects
Despite the benefits of palliative care being well-documented in studies and early palliative care services being strongly recommended by reputable organizations, such as the American Society of Clinical Oncology, many patients did not receive or received late referrals (Pigni et al., 2022). This mainly occurs because oncologists commonly base their referrals on perceived needs and clinical judgment (Smith et al., 2017). Thus, this program development project aimed to create a toolkit to improve early identification and referral to palliative care for adult patients who would benefit from palliative care services. The PICO question that guides this program is: In ambulatory …
A Mixed Methodological Approach To Study The Feasibility Of An End-Of-Life Care Pathway, Noureen Azizullah Mistry
A Mixed Methodological Approach To Study The Feasibility Of An End-Of-Life Care Pathway, Noureen Azizullah Mistry
Theses & Dissertations
Background: The growing significance of end-of-life care in response to the increasing prevalence of chronic illnesses and aging populations has prompted recognition of the need for patient-centred care. Care pathways are employed worldwide to offer comprehensive end-of-life care to patients in various healthcare settings. In Pakistan, there is a recognised need to evaluate the feasibility of introducing an end-of-life care pathway.
Objectives: This study aimed to (a) determine the feasibility of using an end-of-life care pathway for hospital-based and home-based palliative care patients, and (b) explore the experiences and opinions of registered nurses piloting the pathway.
Methods: An explanatory sequential …
About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski
About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski
Electronic Thesis and Dissertation Repository
This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …
Exploring The Hinterland: The Development Of A Person-Centered Music Therapy Method For A Hospice Patient With Lewy Body Dementia, Paige Chaplin
Exploring The Hinterland: The Development Of A Person-Centered Music Therapy Method For A Hospice Patient With Lewy Body Dementia, Paige Chaplin
Expressive Therapies Capstone Theses
This thesis explores the development and implementation of a music therapy method with an individual diagnosed with dementia with Lewy Bodies (DLB) receiving home hospice services. There is very little known about the effect of music therapy on patients diagnosed with DLB. Informed by Tom Kitwood’s Person-Centered Care (PCC) philosophy for dementia care, Yumiko Sato’s Musical Life Review (MLR) model, and Lisa Kelly and Bill Ahessy’s Reminiscence-Focused Music Therapy (RFMT) model, a clinical method was developed to explore the effects of person-centered music therapy on reminiscence, caregiver connection, and identity. I drew inspiration from music therapy concepts by Tony Wigram …
Evaluating The Efficacy Of An Acuity Stratification Tool In Community Based Palliative Care, Madison K. Niederer
Evaluating The Efficacy Of An Acuity Stratification Tool In Community Based Palliative Care, Madison K. Niederer
Doctoral Dissertations
Background: Community-based palliative (CBPC) care teams strive to optimize the quality of life of patients living with serious illness while also providing value-based care. An acuity tool was previously implemented at a CBPC site to promote resource allocation and improve follow-up care. Initial implementation failed, and re-implementation was undertaken.
Objective: Address barriers to acuity tool uptake and provide education on correct acuity tool documentation to improve the number of patients that receive prescribed follow-up care.
Setting/Subjects: An urban CBPC service in the Midwestern United States with a patient panel of 443 patients. Subjects include nurses, social workers, providers, and patients. …
Occupational Therapy In End-Of-Life Care, Shannon Sudrla
Occupational Therapy In End-Of-Life Care, Shannon Sudrla
Student Capstone Papers
Patients at the end-of-life (EoL) experience functional decline in response to terminal illness and the active dying process, inhibiting participation and engagement in meaningful daily activities. Occupational therapy practitioners (OTP) are equipped to address patients’ occupational needs and desires despite their declining capacities; however, the absence of occupational therapy (OT) services in EoL care leaves patients’ occupational needs unmet, directly affecting their quality of life. The literature demonstrates the need for enhanced education and training among occupational therapy students (OTS) and practitioners to better prepare them to work with terminally ill patients who face progressive functional decline and imminent death. …
Assessing Palliative Care Knowledge Among Medicine/Pulmonary Intensive Care Unit Staff To Identify Barriers And Increase Palliative Care Referrals, Ryan Mckendrick
Assessing Palliative Care Knowledge Among Medicine/Pulmonary Intensive Care Unit Staff To Identify Barriers And Increase Palliative Care Referrals, Ryan Mckendrick
DNP Projects
Background: To conduct a needs assessment to identify areas of opportunity for increased awareness of the interdisciplinary medicine/pulmonary intensive care unit (MICU) staffs’ knowledge of palliative care and identify potential barriers to initiating referrals for palliative care consultations. Then provide an educational intervention and assess effectiveness with a post interventions assessment of referrals. The goal of this project is to increase referrals for palliative care consults.
Methods: A pre-/post-survey design will be utilized to assess palliative care knowledge to identify barriers to palliative care consultation referrals. An educational intervention that addresses palliative care knowledge deficits and addresses barriers will be …
Perceptions And Roles Of Genetic Counselors In Perinatal Palliative Care: Where Are We Now?, Amanda Chamberlain
Perceptions And Roles Of Genetic Counselors In Perinatal Palliative Care: Where Are We Now?, Amanda Chamberlain
Dissertations & Theses (Open Access)
After the identification of a life-limiting fetal diagnosis, a perinatal palliative care (PPC) team can provide specialized medical care and emotional support for the family throughout the pregnancy and after delivery. Although the growth of the field of PPC over the last ten years is well-documented, there is only one study to date that explores the experiences of genetic counselors with regards to PPC. This study seeks to further the understanding of genetic counselors’ current perceptions of, experiences with, and roles in the delivery of PPC.
An edited version of the Perinatal Palliative Care Perceptions and Barriers Scale was used …
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington
Doctor of Nursing Practice Final Manuscripts
Acute care nurses caring for end-of-life (EOL) patients often feel unprepared for and undereducated about this high-need population. According to current literature, many nurses lack adequate training in providing EOL care. This project aimed to improve symptom management of dying patients by providing acute care nurses education about EOL symptom assessment and medication use for symptom management. The revised Iowa model, which emphasizes clinician involvement, guided this evidence-based practice project. Sixteen acute care nurses received 30-minute in-person education, consisting of instruction in EOL symptom assessment and management via use of the CARES (comfort, airway, restlessness, emotional, self-care) tool and basic …
Early Integration Of Palliative Care With Curative Oncology Treatment For Patients With Advanced Cancer: Implications For Clinical Nursing Practice, Rhea Rughani
Honors Projects
Palliative care, though clinically established to improve health-related quality of life measures for patients with advanced illness, remains underutilized and largely limited to end of life care. This project aims to inform oncology nursing practice through the analysis of literature supporting the early integration of palliative care with standard curative oncology treatment for patients with clinically advanced cancer. Informed by relevant research, clinical practice guidelines, and improved specialty palliative care training, oncology nurses and nurse practitioners are ideally situated to advocate for and initiate early palliative care integration, to holistically improve the standard approach to complex cancer care.
Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug
Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug
Doctor of Nursing Practice Scholarly Project
As the geriatric population grows rapidly, the importance of utilizing and understanding palliative services continues to rise. Although palliative and hospice care are included in different healthcare courses, misconceptions and lack of knowledge continue to serve as barriers to the utilization of palliative care. The purpose was to assess knowledge, improve palliative care education, and increase understanding of the perspectives of the interdisciplinary team involved in acute patient care. The setting was the telemetry unit in a 300-bed acute care Kansas hospital. A mixed design was utilized with a goal of quality improvement in the use of palliative care. The …
Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar
Effective Therapies And Nursing Approaches: Improving Cognition In Older Adult Stroke Patients, Selyna Baltazar
Nursing | Senior Theses
Background
Ischemic stroke occurs in thousands of older adults throughout the year. Due to the lack of oxygen entering the brain, many patients experience a decline in cognitive function due to ischemic stroke. Cognition is the ability to understand, learn, and remember information which is needed for completing daily tasks. Modern technology has allowed for patients to survive ischemic strokes but has yet to provide proper screening tools and methods for stroke-related cognitive impairment.
Objective
To investigate the best practices for identifying, treating, and caring for patients with a cognitive injury related to a stroke. A review of the research …
Barriers To The Use Of Palliative And Hospice Care Among The Latino Population, Diana Ramirez
Barriers To The Use Of Palliative And Hospice Care Among The Latino Population, Diana Ramirez
Electronic Theses, Projects, and Dissertations
Patients suffering from irreversible and terminal illnesses may benefit from the services provided by Palliative and Hospice Care to control any symptom burden and assist in navigating complex medical decisions. Many patients may express hesitation in accepting and enrolling to this service due to misconceptions. Language barriers may add an additional layer of complexity. This study explored the challenges Palliative Care providers encounter when introducing concept of hospice to Spanish-speaking patients their families for the first time. This study implemented qualitative research methods by using semi-structured one-on-one interviews. Ten members of an In-patient Palliative Care Team at a University Hospital …
Lunch And Learn: Addressing Needs And Resources Of Adolescent And Young Adult Cancer Patients, Philomina Bigelow
Lunch And Learn: Addressing Needs And Resources Of Adolescent And Young Adult Cancer Patients, Philomina Bigelow
MSW Capstones
Historically adolescent and young adult (AYA) oncology patients have been an underserved population. Research indicates they are more likely to experience poorer treatment outcomes, which may result in part from unaddressed biopsychosocial stressors, poor treatment compliance, and poor provider rapport. Research also indicates that oncology providers do not have a formal standardized training they are required to attend on biopsychosocial needs and resources for the AYA population. Oncology care providers need knowledge of the biopsychosocial needs and resources of their AYA patients in order to provide care and resources that remove the effects of biopsychosocial stressors. This project was designed …
The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett
The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett
DNP Projects
Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.
Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …
Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley
Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley
Doctor of Nursing Practice Projects
The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …
A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre
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 …
Deprescribing In The Hospice Population, Who Is Eligible And Who Is Agreeable: A Quality Improvement Project, Ashlee Nicole Smith
Deprescribing In The Hospice Population, Who Is Eligible And Who Is Agreeable: A Quality Improvement Project, Ashlee Nicole Smith
Doctor of Nursing Practice Final Manuscripts
Current evidence recommends and supports deprescribing medications to reduce polypharmacy in the hospice population. The project aim was to determine accurate percentages of deprescribing at three time periods: before hospice admission, at hospice enrollment, and four weeks post hospice enrollment. This project was a retrospective review of the medication administration record (MAR) of patients admitted into Sharp Hospice from a Sharp Healthcare facility. Sharp Hospice, in California, USA, admitted 164 patients during August 2020. Of those, 34 patients were eligible for inclusion in this retrospective quality improvement review. Prior to discharge from a Sharp facility, the percentage of target medications …
A Fully-Automated, Deep Learning-Based Framework For Ct-Based Localization, Segmentation, Verification And Planning Of Metastatic Vertebrae, Tucker Netherton, Tucker James Netherton
A Fully-Automated, Deep Learning-Based Framework For Ct-Based Localization, Segmentation, Verification And Planning Of Metastatic Vertebrae, Tucker Netherton, Tucker James Netherton
Dissertations & Theses (Open Access)
Palliative radiotherapy is an effective treatment for the palliation of symptoms caused by vertebral metastases. Visible evidence of disease is localized on medical images as part of the treatment planning process. However, complicating factors such as time pressures, anatomic variants in the spine, and similarities in adjacent vertebrae are associated with wrong level treatments of the spine. In addition, erroneous manual contouring of anatomic structures is a major failure mode in radiotherapy treatment planning.
The purpose of this study is to mitigate the challenges associated with treatment planning of the spine by automating the treatment planning process for three-dimensional conformal …
Goals-Of-Care & End-Of-Life Quality In Relapsed High-Risk Leukemia: Silent Conversations, Lacy Jo Graham
Goals-Of-Care & End-Of-Life Quality In Relapsed High-Risk Leukemia: Silent Conversations, Lacy Jo Graham
Doctor of Nursing Practice Scholarly Project
BACKGROUND: The distorted association of “end of life (EOL)” with “goals of care (GOC)” has “silenced” crucial goals discussions in patients with relapsed high-risk leukemia, which raises concerns for the provision of care that is inconsistent with patient’s values and preferences.
AIM: The two main goals of this study were to quantify hematologists rate of participation in a GOC pathway initiative during two separate months, then explore their definition and barriers to having/documenting GOC discussions.
DESIGN: Mixed-methods, explanatory sequential design (follow-up explanations variant).
SAMPLE: Quan: Hematology inpatient admissions during the months of October 2020 and January …
Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen
Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen
Nursing DNP Projects
Purpose and Rationale
The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.
Synthesis of Evidence
Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …
Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack
Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack
All Graduate Theses, Dissertations, and Other Capstone Projects
Despite advancing therapies, heart failure remains a progressive disease with high symptom burden. Advance care planning and palliative care assist in maximizing the quality of life for affected individuals. These interventions are supported by current heart failure guidelines yet application into practice is poor. The purpose of this literature review is to investigate the relationship between advance care planning and palliative care interventions on the quality of life of adults with heart failure. A search of the literature was completed between October 20th, 2020 to November 10th, 2020. Databases searched include Academic Search Premier, CINAHL Plus, …
Sleep-Related Problems, Sleep-Related Distress, And Sleep-Related Functional Status Among Adult Inpatients Receiving Palliative Care, Lisa C. Sievers
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 …
Promotion Of Most Forms Through Education About Importance Of Advance Care Planning In Seriously Ill Patients, Nidhi More
DNP Projects
Abstract
Purpose: To establish the importance of early Advance Care Planning (ACP) and improve the utilization of Medical Orders for Scope of Treatment (MOST) forms in seriously ill patients by educating providers and nurses to identify patients who meet specified criteria. The goals of this intervention are reduction of readmissions and better quality of life for this patient population.
Methods: A quasi-experimental design was used for evaluation of an Educational intervention to promote MOST forms, Advance Directives (AD) and Palliative Care (PC) consults. A retrospective and prospective chart review was conducted to determine the number of patients who met criteria …
Association Of Incident Cancer To Low-Value Care And Healthcare Cost Burden Among Elderly Medicare Beneficiaries, Chibuzo Iloabuchi
Association Of Incident Cancer To Low-Value Care And Healthcare Cost Burden Among Elderly Medicare Beneficiaries, Chibuzo Iloabuchi
Graduate Theses, Dissertations, and Problem Reports
In the United States (US), 25% of healthcare spending is considered wasteful because it is spent reimbursing low-value care. Low-value care is the utilization of healthcare services, medical tests, and procedures that have unclear or no clinical benefit to patients but still exposes them to risk. World-wide, low-value care imposes a significant economic burden on patients, payers, governments, and society. Cancer care among older adults > 65 years is one of the biggest drivers of healthcare expenditure in the US and accounts for nearly 40% of all spending, and low-value care among cancer patients is prevalent and contributes to the financial …
Reducing Polypharmacy In Older Adults At End Of Life: The Outcome On Quality Of Life, Melissa Jenson
Reducing Polypharmacy In Older Adults At End Of Life: The Outcome On Quality Of Life, Melissa Jenson
All Graduate Theses, Dissertations, and Other Capstone Projects
Background: Older adults at the end of life are commonly prescribed multiple medications which can lead to polypharmacy. Research has shown that optimizing medications through targeted deprescribing reduces inappropriate medications, reduces adverse effects and improves select outcomes. However, the impact of deprescribing remains uncertain--specifically whether this intervention improves quality of life (QOL). Objective: Explore polypharmacy in older adults at the end of life examining outcomes of deprescribing on the QOL. Methods: A systematic literature search using Academic Search Premier, CINAHL, Medline, JSTOR and Nursing and Allied Health Database was conducted between October 2020 to November 2020. Select articles …
The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby
Doctors of Nursing Practice (DNP) Final Projects, 2020-current
The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute …
Earlier Palliative Care Referrals For Nephrology Patients, Jerold Cohen
Earlier Palliative Care Referrals For Nephrology Patients, Jerold Cohen
Doctor of Nursing Practice (DNP) Projects
Palliative care prevents and relieves suffering through the early identification and treatment of pain and other symptoms, which can be physical, psychosocial, or spiritual (World Health Organization, 2018). It is usually considered a service provided to oncology patients and has positively impacted their treatment. However, it is not as common for many other diseases where the patient would benefit from palliative care involvement. Presently, if palliative care is offered to nephrology patients, it is after they have started dialysis and are having second thoughts whether to continue this treatment plan as it has either become less effective or is interfering …