Palliative Care Commons^™

The Impact Of Procalcitonin In Assessing Outcomes In Pediatrics Severe Trauma Cases: A Three-Year Experience From A Tertiary Hospital, Waleed H. Albuali

BioMedicine

Background Although procalcitonin levels are raised in patients with systemic inflammation, its usage in pediatric patients, particularly those in the intensive care unit who are most susceptible to sepsis. Methods It is a retrospective research study that included pediatric patients aged more than two weeks who were brought to the King Fahd Hospital of the University's PICU owing to serious trauma or post-acute postoperative occurrences from January 2017 to December 2019. At 24 hours after admission, data such as age, gender, comorbidities, trauma severity as measured by the Injury Severity Score, and PRISM III score were collected. Results Following a …

Caractéristiques Et Qualité Des Ressources Éducatives Libres En Soins Palliatifs Et De Fin De Vie : Une Revue Intégrative, Marie-Violaine Dubé Ponte, Ariane Plaisance, Diane Tapp, Romane Couvrette, Marie-Claude Laferrière

Quality Advancement in Nursing Education - Avancées en formation infirmière

Résumé

Contexte. Les soins palliatifs et de fin de vie (SPFV) visent à soulager la douleur, apaiser la souffrance et à préserver la dignité des personnes présentant un pronostic réservé. À l'échelle mondiale, seulement 14 % des personnes qui en ont besoin bénéficient de SPFV. Pour offrir des SPFV de qualité, les professionnel(le)s de la santé et des services sociaux doivent détenir des connaissances à jour. Les ressources éducatives libres (REL) ont le potentiel d’augmenter et de maintenir les connaissances. Il s’agit de matériel d’enseignement, d’apprentissage ou de recherche disponible en ligne, dont le contenu est protégé par une licence …

A Dnp Quality Improvement Project To Assess The Traumatic Brain Injury Survivor And Their Family Caregivers' Coping And Resiliency, Marcelle Angall-Leonce

DNP Research Projects

Abstract

Background: Traumatic brain injury (TBI) support groups are vital to TBI survivors in the community and provide resources to family caregivers (FCs) to mitigate caregiver burden. Resiliency is a necessary characteristic to cope with chronic diseases and the demands of caregiving. However, a gap exists in how TBI support groups mitigate family stress and empower coping and resiliency for the TBI survivor and FCs. Method: The quality improvement project assessed TBI survivors' and FCs' coping and resiliency before and after an educational module on coping, resiliency, and self-care strategies. Intervention: A quality improvement project in a support group of …

Medication Cost Reduction And Substitution Strategies Through The Mymetrx Program At Catholic Hospice, Ana M. Sanchez Monroig, Tracy Romanello, Joseph Solien, Sanaz Kashan, Angel E. Sanchez Artiles

East Florida Research Day 2023

Please see supplemental content for full abstract with references.

Introduction: As healthcare costs continue to rise, and with the growing awareness of the potential harms of polypharmacy, there is an ongoing need to explore strategies to optimize medication use in hospice settings. Strategies include deprescribing and medication substitutions, which ensure the safety and comfort of patients but can also lead to significant medication cost reduction.

Objectives: The primary objective of this study was to evaluate the impact of the MyMetRx program on medication cost reduction and medication substitutions within the context of Catholic Hospice. The program aimed to optimize medication …

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 …

Improving Comfort And Confidence With Advance Care Planning In Primary Care, Thomas Krajewski, Donald Courtney, Tyler Kilgore

South Atlantic Division Research Day 2023

No abstract provided.

The Effect Of Early Palliative Care Consultation For Patient With Traumatic Brain Injury On Procedure Utilization, Length Of Stay And Discharge Location, Abdulelah Almutairi, Donald Courtney, Heather Rhodes

South Atlantic Division Research Day 2023

No abstract provided.

Advance Care Planning Documentation At Mad River Family Practice, Nicole A. Walch

Family Medicine Clerkship Student Projects

Advance care planning is a powerful tool that helps to guide clinicians and family members to make care decisions that align with a patients values when that patient is unable to speak for themselves. Advance care planning documents such as advance directives are the primary tool used to put these patient preferences in writing, but there is little information about the true rates of document completion in Vermont. This project was focused on determining how many patients at the Mad River Family Practice had advance care planning documents, developing a tracking tool in the electronic medical record to see trends …

Palliative And End-Of-Life Care Access For Immigrants Living In High-Income Countries: A Scoping Review, Gertrude G. Phiri, Joyce Muge-Sugutt, Davina Porock

Research outputs 2022 to 2026

This scoping review aimed to explore what is known about palliative and End-of-Life (EOL) care access by immigrants with culturally and linguistically diverse (CALD) background living in high-income Organization for Economic Co-operation and Development (OECD) countries. CaLD immigrants have low utilization of palliative care services with patients’ family members taking up the role of caring, leading to immigrants not fully benefiting from the specialized services that are offered to alleviate suffering and promote quality of life. While there is some research in this area mainly in Europe, it cannot be said about all high-income OECD countries. Achieving person-centered care in …

Estimulación Cognitiva Y De La Actividad Fisica En La Persona Mayor - Una Experiencia Desde La Práctica, Maria Victoria Rojas Martinez, Adriana Hernandez Bustos, Blanca Gregoria Melo Melo

Ciencias de la Salud

El trabajar con la persona mayor que presenta limitación física o mental, lleva a la aparición de grandes retos para el estudiante y futuro profesional de enfermería, más aún cuando el campo de acción es el hogar, porque el cuidado será compartido entre la persona, el cuidador o grupo familiar, dentro de su propio espacio, por lo tanto, se convierte en una intervención individual con el uso de recursos propios y generalmente con la participación directa del cuidador o acompañante. Para el cuidado en el hogar el autocuidado es base fundamental para el cumplimiento de metas en la salud de …

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 …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Podium Persentation: Trauma-Informed Care In Palliative Care, Amber Piranio

2022 Providence Nurse Research Conference

No abstract provided.

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

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 …

Literature Review: Palliative Care In The Emergency Department, Alice Chang, James Espinosa, Alan Lucerna, Neelesh Parikh

Rowan-Virtua Research Day

With current medical advances, our patient population continues to age. This poses new challenges for healthcare practitioners to provide for elderly patients with complex and multifactorial medical needs. Particularly, this is a growing challenge in the emergency department (ED), where patients often present towards the last months of their lives. A study conducted by UCSF indicates 75% of patients in their last 6 month of life visited the ED. 56% to 99% of older adults do not have advance directives available at ED presentation. Therefore, ED visits towards the end of life is an opportune teaching moment for physicians to …

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

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 …

Advantages Of Early Utilization Of Palliative Care In The Pediatric Icu: A Scoping Review, Shelby Noel Cain Bsn, Rn, Cpn, Dana Pabalate Zimmerman Msn, Rn, Charis Elizabeth Oji Msn, Aprn, Cpnp-Pc/Ac, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative …

When Healthcare Leadership And Philanthropy Lead To An Improved Patient Experience: The Paul Lepsoe Music Initiative, Sara Olivier Rn Bscn Mn, Corianne Bell Ba Mus, Cheryl Jones Registered Psychotherapist, Mta, Phd, Jerry M. Maniate Md, M.Ed, Frcpc, Facp

Patient Experience Journal

Through an unprecedented collaboration between an academic acute tertiary care hospital (The Ottawa Hospital (TOH) and a community-based professional orchestra (Ottawa Symphony Orchestra (OSO), the Paul Lepsoe Music Initiative represented an innovative partnership focused on improving patient care via (a) the integration of live music in waiting areas of the hospital’s Cancer Center and (b) the creation of individualized music therapy interventions on the inpatient Palliative Care Unit. Patient, family, and volunteer/staff feedback further refined the intervention throughout the duration of the Initiative; a qualitative process that provided insight into the overall patient experience and opportunities for patients and families …

Alzheimer's And Patient Caregiver Burnout: A Review Of The Literature, Madeline Hekeler

James Madison Undergraduate Research Journal (JMURJ)

The term “silent epidemic” is fitting for Alzheimer’s disease (AD), as its negative impact is widely felt but rarely discussed. Burnout among AD caregivers has become an epidemic of its own as caregivers experience an increase in health risks, stress, and financial burden. This literature review focuses on caregiver burnout and how imperative it is that caregivers are better supported in their role. Researchers have developed instruments to assess and intervene in caregiver burnout that have shown effectiveness among caregivers and their families.Nevertheless, further longitudinal research is warranted regarding more effective interventions, including stress management and social support mechanisms.

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 …

Perishing Personhood, Alaina Mann

UNO Student Research and Creative Activity Fair

Many people think that art and science do not overlap, especially in an educational sense. As someone who is both a biology and studio art major, I wanted to explore this mentality. This past semester I dived into a project to prove just how much these subjects can work together to expand our understanding of how art can be used for research purposes in a medical setting. With support from my Life Drawing professor, I was able to create multiple drawings from life and from photographs centered around my grandmother's Alzheimer’s Disease during my frequent visits to her nursing home. …

Early Diagnosis, Biomarkers And Intervention In Alzheimer’S Disease, Thomas J. Grabowski Md

Palliative Care Institute

New Trends in Dementia Diagnosis and Care
Dementia in Primary Care: Prevalence to Partnerships

Thomas J. Grabowski MD

Director, UW Memory and Brain Wellness Center

Director, Alzheimer Disease Research Center

University of Washington

Dementia And Primary Care, Barak Gaster Md, Facp

Palliative Care Institute

Dementia and Primary Care webinar

Part 2

Role Of Optical Coherence Tomography Angiography To Differentiate Intraretinal Microvascular Abnormalities And Retinal Neovascularization In Diabetic Retinopathy, Abdul Sami Memon, Nasir A. Memon, Pir Salim Mahar

Department of Surgery

Objective: To assess proliferative diabetic retinopathy (PDR) and to describe the difference in angiographic representation of new vessels (NVs) and Intra retinal microvascular abnormalities (IRMA) on optical coherence tomography angiography (OCTA).
Methods: A cross-sectional observational study was performed at ISRA Postgraduate Institute of Ophthalmology, Karachi, from March 2018 to September 2018. Forty-two eyes of 21 patients with history of diabetes mellitus (DM) were examined. Twenty-eight eyes with a clinical diagnosis of severe non proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) according to early treatment diabetic retinopathy study (ETDRS) were included and evaluated using Swept source optical coherence tomography …

Dementia In Primary Care: Prevalence To Partnerships, Kristoffer Rhoads Phd

Palliative Care Institute

Dementia in Primary Care: Prevalence to Partnerships. 01.26.22 Part 1

Ten-Year Trends Of Utilizing Palliative Care And Palliative Procedures In Patients With Gastric Cancer In The United States From 2009 To 2018 - A Nationwide Database Study, Moon Kyung Joo, Ji Won Yoo, Zahra Mojtahedi, Pearl Kim, Jinwook Hwang, Ja Seol Koo, Hee Taik Kang, Jay J. Shen

Internal Medicine Faculty Publications

Objectives: Little is known about the current status and the changing trends of hospitalization and palliative care consultation of patients with gastric cancer in the United States. The aim of this study was to evaluate the changing trend in the number of hospitalization, palliative care consultation, and palliative procedures in the US during a recent 10-year period using a nationwide database. Methods: This was a retrospective study that analyzed the National Inpatient Sample (NIS) database of 2009–2018. Patients aged more than 18 years who were diagnosed with a gastric cancer using International Classification of Diseases (ICD)-9 and 10 codes were …

Enhancing Hospitalists' Knowledge In Relation To Palliative Care, Herline Raphael

DNP Research Projects

Abstract

Palliative care was not the specialty of many hospitalists; thus, communication was hindered regarding ELC and advanced directives. Despite healthcare utilization in the United States, inadequate treatment of serious illnesses continues due to the lack of provider education and understanding of ELC (palliative and hospice care). Hospitalists are not formally or informally trained to care for patients that need palliative or hospice care. A quantitative, quasi- experimental and qualitative approach was utilized to determine if hospitalists who received educational training on palliative care communication and collaboration improved knowledge, skills, and collaboration when caring for end-of-life or critically ill patients. …