Palliative Care Commons^™

Evidence-Based Toolkit To Evaluate Telemedicine Delivery Of Palliative Care, Aubrey E. Dwyer

Doctoral Projects

Advances in healthcare have led to many individuals with cancer to live longer, however the quality of life of these individuals has decreased. Palliative care is a medical sub-specialty that can assist to care for individuals with a life-limiting illness such as cancer. However, the access to palliative care services in rural communities is limited. According to the Institute of Medicine (IOM) report Dying in America, increasing access to palliative care will not only enhance the quality of life for patients with a life-limiting illness, but also contribute to a more sustainable healthcare system. The key stakeholders within a Midwest …

An Evidence-Based Toolkit For Early Identification Of Frail Inmates, Morgan A. Kochajda

Doctoral Projects

There are significant numbers of people aging and nearing end of life while being incarcerated (Richter & Hostettler, 2017). Currently the Department of Corrections (DOC) does not have a standardized process for early identification of inmates who may need increased end of life care services. A potential solution to this problem would be the use of a frailty screening tool for early identification of those inmates who may need increased resources. At this time, there is not a formalized relationship between a Midwest hospice and palliative care department and the DOC. There is a desire from leadership of the hospice …

An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter

Doctoral Projects

Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.

Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …

Evidence Doesn’T Change Prescribing Patterns…So What Does?, Ali Rida, Anthony Brooks

Clinical Research in Practice: The Journal of Team Hippocrates

The authors write in support of critical analysis of clinical research, as a corrective to the physician's urge to "do something" even when no evidence of benefit exists.

Handout: Palliative Care Institute And Northwest Life Passages Coalition - Helpful Links, Palliative Care Institute, Western Washington University, Northwest Life Passages Coalition

Northwest Life Passages Coalition Documents

The Palliative Care Institute (PCI) at Western Washington University aims to help those who actively seek to live their lives to the fullest, with their pain and suffering alleviated, their fears and questions heard and addressed, and their relational, spiritual, and cultural needs met. PCI believes that the changes in serious illness and end of life care envisioned in the Northwest Life Passages Coalition Blueprint will occur through changes in training for clinical providers and also by activating our community.

The Whatcom Alliance for Health Advancement (WAHA) is a nonprofit organization based in Bellingham, Washington whose mission is to connect …

Single-Subject Designs And Practice-Based Research In Palliative Care: A Letter To The Editor., James Gerhart, Dennis J. Hand, Michael Hoerger, Sean O'Mahony

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Emergency Medicine Palliative Care Access (Empalla): Preliminary Data From A Multi-Center Randomized Controlled Trial, Abigail M. Schmucker, Ba, Deborah J. Shim, Bs, Corita R. Grudzen, Md, Mshs, Jeanne Cho, Mph, Keith Goldfeld, Drph

Phase 1

Introduction: Emergency department (ED)-initiated palliative care has been shown to improve patient-centered outcomes in older adults with serious illnesses, but the optimal modality for providing such interventions is unknown. The EMPallA trial compares nurse-led, telephonic case management with specialty, outpatient palliative care on: 1) patient quality of life (QOL); 2) healthcare utilization; 3) loneliness and symptom burden; and 4) caregiver strain, QOL, and bereavement.

Objective: Summarize preliminary demographic and QOL data for the EMPallA cohort.

Methods: A pragmatic, parallel, two-arm randomized controlled trial is enrolling 1350 ED patients across 9 EDs over 3 years to compare the effectiveness of palliative …

A Nurse Navigator-Driven Program To Increase Palliative Care Referrals For Advanced Heart Failure Patients, Margaret Richter, Linda Desitter, Adam Mizgajski, Deborah Strohecker

Articles, Abstracts, and Reports

No abstract provided.

Death With Dignity For The Seemingly Undignified: Denial Of Aid In Dying In Prison, Kathleen Messinger

Journal of Criminal Law and Criminology

The medical community has fundamentally changed how we think about life and death. Humans in privileged parts of the world are living longer and have access to life-saving treatment. The focus on quantity of life then has shifted to emphasizing quality of life and questioning whether longevity should at the expense of comfort or satisfaction. The conversation surrounding quality of life, and by extension end-of-life care, has included whether a competent adult has a right, or should have a right to end their own life on their own terms. The history of aid in dying is wrought with political ideology, …

Handout: Everyone Needs An Advance Directive! Not Everyone Needs A Polst!, Northwest Life Passages Coalition

Northwest Life Passages Coalition Documents

The Advance Directive and Physician Orders for Life Sustaining Treatments (POLST) are both important tools for documenting your wishes for care. They are each designed to accomplish specific goals - it is important to understand who they are intended for and what they do!

Search Strategy For "The Benefits, Burdens, And Risks Of Participation In Pediatric Palliative Care And End Of Life Research: A Systematic Review", Pamela S. Hinds, Vanessa N. Madrigal, Cynthia J. Bell, Cynthia M. Schmidt, Amy R. Newman, Kim Mooney-Doyle, Jessica L. Spruit, Tessie October, Christine A. Fortney, Melissa Kurtz Uveges, Kitty Montgomery, Katherine Patterson Kelly, Meaghann S. Weaver

Search Strategies

No abstract provided.

Effect Of Neoadjuvant Chemoradiation On Preoperative Pulmonary Physiology, Postoperative Respiratory Complications And Quality Of Life In Patients With Oesophageal Cancer, J. A. Elliott, L. O'Byrne, G. Foley, C. F. Murphy, Suzanne Doyle, S. King, E. M. Guinan, N. Ravi, V. Reynolds

Articles

Background: It remains controversial whether neoadjuvant chemoradiation (nCRT) for oesophageal cancer influences operative morbidity, in particular pulmonary, and quality of life. This study combined clinical outcome data with systematic evaluation of pulmonary physiology to determine the impact of nCRT on pulmonary physiology and clinical outcomes in locally advanced oesophageal cancer.

Methods: Consecutive patients treated between 2010 and 2016 were included. Three-dimensional conformal radiation was standard, with a lung dose–volume histogram of V20 less than 25 per cent, and total radiation between 40 and 41⋅4Gy. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity …

Creative Approaches To End Of Life Care - Poster.Pdf, Amanda C. Adams, Matthew Nelson, Christian Bruni, Susan Cavanaugh

Amanda C. Adams

No abstract provided.

Non-Pharmacological Solutions To Sleep And Circadian Rhythm Disruption: Voiced Bedside Experiences Of Hospice And End-Oflife Staff Caregivers, Rana Sagha Zadeh, Elizabeth Capezuti, Paul Eshelman, Nicole Woody, Jennifer Tiffany, Ana C. Krieger

Publications and Research

Background: Sleep disturbance is a significant issue, particularly for patients with advanced terminal illness. Currently, there are no practice-based recommended approaches for managing sleep and circadian disruptions in this population. To address this gap, a cross-sectional focus group study was performed engaging 32 staff members at four hospices/end-of-life programs in three demographically diverse counties in New York State.

Methods: Participants responded to structured open-ended questions. Responses were transcribed and subjected to qualitative content analysis. The themes and recommendations for improved practice that emerged were tabulated using Atlas TI qualitative software.

Results: This report details the experiences of hospice and end-of-life …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Community Engagement: The Missing Piece In The Palliative Care Puzzle, Marie Eaton

Palliative Care Institute

Community Engagement: The Missing Piece in the Palliative Care Puzzle, is a presentation at the Washington End-of-Life Coalition Annual Meeting by Marie Eaton, Community Champion, Palliative Care Institute, Woodring College of Education, Western Washington University and Chair of the Northwest Life Passages Coalition.

Needs Assessment For Palliative Care In Pediatric Oncology: An Integrative Literature Review, Tabitha Negrete

Grace Peterson Nursing Research Colloquium

Abstract

Background: Cancer is the leading cause of non-accidental death in childhood. Cancer is the primary disease for which pediatric palliative care services are utilized worldwide. Improvement in pediatric palliative care has been identified as an ongoing research priority. There are still significant gaps in current knowledge of pediatric palliative care because education has not been integrated into curriculum and clinical experiences.

Objectives: The purpose of this integrative literature review aims to provide a comprehensive review of current research about the need of nursing education on palliative care for long-term care in pediatric oncology.

Methods: This integrative literature review focused …

Euthanasia, Assisted-Suicide, And Palliative Sedation: A Brief Clarification And Reinforcement Of The Moral Logic, Peter A. Depergola Ii

Journal of Health Ethics

A persistent misunderstanding of the moral distinctions between the practices of euthanasia, assisted suicide, and palliative sedation suggests a critical need to revisit the relationship each shares with licit medical practice in the context of palliative care. To that end, this essay grounds its arguments in two, straightforward premises: (i) the licitness of medical practice is largely determined by the balance between (a) good ends, (b) proportionate means, (c) appropriate circumstances, and (d) benevolent intentions; and (ii) whereas palliative sedation employs criteria A-D (above), both euthanasia and assisted suicide fail to secure criteria A-C. Drawing from this syllogism, the aim …

Community Conversation: Community Education And Activation, Northwest Life Passages Coalition

Northwest Life Passages Coalition Documents

In 2014, a community task force wrote a Blueprint that outlines steps to make Whatcom County a community of excellence for those with serious illness or facing death and their families. The Blueprint has five pillars: Advance Care Planning, Clinical Care, Provider Training , Community Culture and Activation and Financial Sustainability.

Reconstruction Of Heel Soft Tissue Defects Using Sensate Medial Plantar Flap, Mihaela Pertea, Natalia Velenciuc, Oxana Grosu, Bogdan Veliceasa, Vladimir Poroch, Sorinel Lunca

Journal of Mind and Medical Sciences

Introduction. Reconstruction of heel soft tissue defects represents a true challenge for any surgeon due to the particularities of this anatomical region. The tissue used to reconstruct the heel area must be resistant, innervated, and adapted to take over the body weight. Innervated medial plantar fasciocutaneous flap is one of the best solutions to cover defects at the heel level.

Materials and Methods. We studied 5 patients, 4 males and one female, aged 42 to 67 years, who presented heel soft tissue defects of various etiologies. In all cases, the used reconstructive method was an insular innervated medial plantar fasciocutaneous …