Palliative Care Commons^™

Implementation Of The Integrated Palliative Outcome Scale (Ipos) Into Palliative Care Practice, Lisa A. Pezold

Dissertations

Abstract

Problem: The Visiting Nurse Association of Greater St. Louis (VNA) has a grant-funded, palliative care program called Advanced Illness Management (AIM). The Integrated Palliative Outcome Scale (IPOS) is a tool for providers to identify symptoms. The VNA implemented the IPOS in 2017. A previous quality improvement project revealed that IPOS symptoms were addressed less than 95% of the time leaving patients to suffer from burdensome symptoms, thereby reducing their quality of life.

Methods: Providers were educated on the importance of addressing all symptoms with pharmacologic or nonpharmacologic interventions and the impact the interventions have on the AIM program, grant …

Reality Check: Life Is 100% Fatal. Let's Talk About It, Micki Jackson

Palliative Care Institute

REALITY CHECK: Life is 100% fatal. Let's talk about it, is a guest editorial by Micki Jackson, community and patient advocate for out-patient palliative care and advance care planning in Bellingham, WA.

Exploring Parental Wishes And Personhood In The Grey Zones Of Neonatal Resuscitation, Alison Lindsay

Honors Projects

The intense societal debate churning around the moral status of fetuses includes topics such as qualifications for personhood, the role of the autonomous decisions of a fetus’ mother, and the obligations of society to protect fetuses. This paper analyzes extending this discussion to newborns in five sections. The first section presents a literature review of responses to a philosophical paper about the respective interests of parents and fetuses and newborns, elaborating on aspects of personhood and parental decision-making. The second section presents a literature review of medical and nursing discussion around resuscitation for extremely premature newborns, focusing on similar evaluations …

Expedited Referral To Inpatient Hospice Unit Through The Jefferson Methodist Hospital Emergency Department, Brian Fromm, Md, Kory London, Md, Facep

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

Palliative care is the branch of healthcare that aims to provide symptomatic relief for patients with chronic or incurable medical conditions. Hospice is a subcategory of palliative care in which the focus is placed on comfort to the exclusion of further curative efforts, generally reserved for patients with a life expectancy of six months or less.

The American College of Emergency Physicians (ACEP) Choosing Wisely guidelines recommend that emergency physicians refer appropriate patients to hospice and palliative services. Preventing hospital admission in favor of transfer to an inpatient hospice unit “can benefit select patients resulting in both improved quality …

Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Kori Fitzgerald Bsn, Rn, Phn, Fnp/Dnp Student

Doctor of Nursing Practice Final Manuscripts

Title: Utilization of Telehealth for Palliative Care Follow-up Visits

Background: A vital part of cancer management is the implementation and integration of palliative care, to prevent and relieve suffering and to improve quality of life for patients with serious chronic illness. However, access to palliative care services continues to be inadequate. There is a nationwide shortage of skilled palliative providers and the supply is insufficient to meet the growing demand.

Purpose of Project: Implementing telehealth visits with palliative care patients with advanced cancer at the UCSD Moores Cancer Center has the potential to maintain patient satisfaction with …

Honoring A Family’S Goals About A Meaningful Life And Death: A Case Study, Lauren Schmidt

Palliative Care Institute

Honoring a Family’s Goals about a Meaningful Life and Death: A case study: Lauren Schmidt, MSW, LICSW, palliative care consultant in the Division of Bioethics and Palliative Care at Seattle Children’s Hospital.

Objectives:

• To explore how a family’s own micro culture impacts views on quality of life and their child’s death.
• To identify how a family’s understanding of their child’s illness can evolve and change over time and how that impacts their choices.
• To talk about and understand some of our own internal biases, why they are normal, and how we can incorporate awareness into our practice so that …

Not If But When: Books For Young People About Death And Loss, Thom Barthelmess, Sylvia Tag, Marie Eaton

Palliative Care Institute

Children who are facing a serious illness or have experienced a death in their family can be reassured by stories of other children who have had a similar experience. These stories help them understand better what has happened in their own family while at the same time offering the comforting knowledge that they are not alone in their feelings. In this session we will explore how books provide a way to begin these conversations, giving the child permission to talk about death and communicating that we are interested in her feelings and questions.

There Is Always Hope: The Essence Of Spiritual Care, Tessie Mandeville

Palliative Care Institute

There Is Always Hope: The Essence of Spiritual Care: Tessie Mandeville, Chaplain, PeaceHealth St Joseph's Medical Center

Objectives:

• Understand a working definition of spirituality and how it is an essential component of wholeness
• Distinguish between “hope”, “cure”, and “optimism”
• Describe recent articles on the science of hope and how hope protects the brain
• Conclude that there is reason (and science) for hope

Embracing Cultural Humility In Palliative Care: A Journey From The Professional To The Personal, Arika Patneaude

Palliative Care Institute

Arika Patneaude, MSW, LICSW - Embracing Cultural Humility in Palliative Care. Patneaude is part of the interdisciplinary team at Children's Hospital and will help us explore how cultural perspectives and beliefs intersect with access to and implementation of palliative care.

Objectives:

• Examine how our own personal cultural identities can (and do) intersect with those of the patients and families we serve

• Understand how the medical model “culture” can impact how a patient and family may make medical decisions at the end-of-life

• Describe how cultural identity impacts decision making at the end-of-life

• Explore the importance of understanding …

Pediatric Palliative Care: Treating The Whole Infant, Child, Or Teen, Jennifer Kett

Palliative Care Institute

Jennifer Kett, MD - Pediatric Palliative Care: Treating the Whole Infant, Child, or Teen. Kett specializes in complex critical care, working as part of an interdisciplinary team at Mary Bridge Hospital in Tacoma that provides family-centered care for children with chronic or life-threatening illnesses. She will address the special challenges of working with critically ill children and youth.

Objectives:

• Use cases to more deeply investigate the unique challenges faced in pediatric palliative care (medically, ethically, legally and socially)
• Outline as a group an approach to managing some of these challenges
• Describe the ways interdisciplinary team members are critical to overcoming …

Program - 2019 Palliative Care Institute Conference: Palliative Care: Treating The Whole Person, Palliative Care Institute

Palliative Care Institute

Speakers and workshops addressing the interdisciplinary nature of palliative care, and the importance of addressing the totality of the patient’s relational existence—physical, psychological, cultural, social, and spiritual.

A Unique Model For Perinatal Palliative Care In A Level Iv Neonatal Intensive Care Unit, Kelstan L. Ellis Do, Megan Tucker Md

Research Days

No abstract provided.

Does Palliative Care Involvement Influence Location Of Death?, Joy L. Solano

Research Days

No abstract provided.

Does Pediatric Palliative Care Involvement Influence Location Of Death?, Joy Solano, Meghna Singh, Ashley K. Sherman, Jennifer Linebarger

Posters

This study describes the influence of a palliative care team on location of death and location of death discussions with patients/caregivers, and determines whether location of death discussions influence location of death.

With palliative care or a location of death discussion, patients were less likely to die in the PICU and more likely to die at home. Location of death discussions were more likely to occur if a palliative care team was involved.

A Unique Model For Palliative Care In A Level Iv Neonatal Intensive Care Unit, Kelstan L. Ellis Do, Megan Tucker, Jennifer Linebarger

Posters

This poster describes a review of the relationship between the Fetal Health Center and the Palliative Care team as the Palliative Care Team follows the patient family from prenatal through neonatal intensive care.

Increasing Adult's Awareness Of The Importance Of End-Of-Life Care Discussions, Taylor Gardner

Capstone Projects and Master's Theses

For many American families, end-of-life care is often not discussed, until advanced illness or injury has fully disrupted everyday life. There are many benefits to discussing end-of-life care prior to any medical complications. Research has shown that individuals who plan their end-of-life processes with a hospice service provider and family members report a higher quality of death than individuals receiving common health care during their final six months of life. In order to make families and friends more comfortable with end-of-life discussions, I will conduct two one-hour educational sessions to students at California State University, Monterey Bay.

Northern New England Palliative Care Teleconsult Research Laboratory, Ava Daruvala, Rebecca N. Hutchinson, Eric Anderson, Paul Han

Maine Medical Center

Introduction:

• Palliative care (PC) is an approach that improves the quality of life of patients and their families.

• Delivery of PC via telehealth technology (tele-PC) has been proposed as a solution to increase access to PC in rural areas. • The feasibility, acceptability, and effectiveness of applying telehealth technology to PC remains unknown.

• The overarching purpose of the proposed study is to 1) evaluate the feasibility and acceptability of a tele-PC intervention for seriously ill patients, and 2) generate pilot data to better understand provider-patient communication during tele-PC consultations

What’S Happening To Our Patients In Their Final Year Of Life?, Teresa Letellier, Amy Haskins, Christina Holt

Maine Medical Center

We want to “die well” which includes:

• Effective symptom management

• Receiving care consistent with wishes Who achieves this, and how?

• Primary care physicians (PCPs) – Insufficient time and training

• Palliative care physicians – Better quality care and decreased health care cost in last years of life

• “Surprise Question” – “Would you be surprised if this patient dies in the next year?”

• To recognize our sickest patients and discuss goals of care and consult palliative care, if appropriate • “Advance care planning tab” – To record code status, advance directive, POLST forms, medical power of …

Impact Of Palliative Care Consultations For Patients Admitted To Maine Medical Center With Acute Exacerbations Of Copd, Benjamin Jarrett, Isabella Strumpf, Rebecca Hutchinson

Maine Medical Center

Background and purpose:

• COPD is the 3rd leading cause of death.

• Specialty Palliative Care (PC) is underutilized in COPD patients.

•PC involvement has been shown to improve quality of life and satisfaction with overall care.

• We sought to evaluate the association of receipt of palliative medicine consultation during an admission for acute exacerbation of COPD with a documented Goals of Care conversations and/or presence of an advanced directive and/or POLST.

Advance Care Planning In Whatcom County, Marie Eaton

Palliative Care Institute

Marie Eaton, Chair, Northwest Life Passages Coalition Community Champion, Palliative Care Institute made a presentation on April 16, 2019, "Healthcare Decisions Day" to the Chuckanut Health Foundation on the topic of "Advance Care Planning in Whatcom County".