Digital Commons Network^™

Referral Patterns From Long-Term Care Services To Palliative Care: Perceptions Of Directors Of Nursing, Karen S. Sharrah, Dnp, Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Palliative care referrals are important in long-term care facilities because they are the first step in generating the services that the patient may need. This study looked at the phenomena of how Directors of Nursing in long-term care facilities that had access to palliative care services determined if a referral was needed.

Objectives: The purpose of this study was to gain a deeper understanding of the decision- making process used by Directors of Nursing for referrals. The study’s aims were to determine what factors prompt a referral in long-term care settings. The primary research question was: How …

We Are The Medicine, Madalynn Wendland, Toni Speed

Interprofessional Education

We are all healers— to ourselves, each other and the world around us. Whether you are on the path of becoming a health professional, or have been in practice for a long time, this half-day workshop will help you to view healing from a holistic perspective that draws from the ancient traditions while respecting contemporary science.

Physician Assisted Suicide: Attitudes Of The Minnesota General Population, Jennifer M. Bretscher, Tammy J. Estrem

All Electronic Theses and Dissertations

Having the choice to hasten death via physician assisted suicide (PAS) is becoming increasingly more popular in the United States. The majority of states do not yet have laws that legalize PAS, but many, including Minnesota, are currently entertaining legislation to allow PAS as an end-of-life option if a person is over the age of 18 and has a terminal illness with only six months to live. To date, little research has been done to evaluate the attitudes about PAS in the Minnesota general population. The goal of this study was to determine whether demographics, namely, age, gender, educational level, …

2017-2018 Pediatric Subspecialty Trainees, Children's Mercy Hospital

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in allergy/immunology, child abuse pediatrics, child neurology, clinical child psychology, clinical pharmacology, developmental-behavioral pediatrics, hospice & palliative care, laboratory genetics & genomics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric anesthesiology, pediatric bioethics, pediatric cardiology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric ophthalmology, pediatric otolaryngology, pediatric pulmonology, pediatric radiology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, pediatric residency and med/peds residency.

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

Knowledge And Attitudes Of Emergency Room Nurses Regarding Palliative Care Patients, Pearl Alethea Harrison

Walden Dissertations and Doctoral Studies

Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the …

Identifying Veterans With Opioid Use Disorder That Could Benefit From Referral For Evidence-Based Medication-Assisted Treatment, Emily Hampton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Current treatment guideline recommendations published by the American Society of Addiction Medicine for Opioid Use Disorder (OUD) include both psychotherapy and Medication- Assisted Treatment for optimal management of this chronic medical illness. Military veterans are at an increased risk for fatal outcomes related to opioid overdoses due to a higher prevalence of depression/Post-Traumatic Stress Disorder (PTSD) and self-medicated substance use compared to their civilian counterparts. Additionally, many have been diagnosed with OUD but are not being treated in accordance with current treatment recommendations.

In an effort to increase access to treatment and combat the opioid epidemic, the Lexington VA Medical …

Evaluation Of Pharmacist Involvement In Outpatient Transitional Care Management, Katharine Lundy Pharmd

Pharmacy Residency

Presentation given at Great Lakes Pharmacy Residency Conference 2018

Home-Based Primary Care: Impact On Cost And Patient Satisfaction, Sarah R. Tupper

All Graduate Theses, Dissertations, and Other Capstone Projects

The aging American population means more people will need healthcare than ever before. Many of these people are or will be Medicare beneficiaries who are predicted to be completely or mostly homebound at some point in time. This literature review was conducted to investigate Home-based Primary Care (HBPC) and whether or not this care delivery model has impacts on cost and patient satisfaction when compared to traditional outpatient encounters. A comprehensive and robust search of the literature was conducted using four different healthcare literature databases. Relevant articles were included if the site of care was ambulatory or office-based and if …

Nicu Nurses' Suggestions For Improving Obstacles In End-Of-Life Care, Rebecca Faye Isaacson

Theses and Dissertations

Background: Approximately 25,000 pediatric deaths occur in hospitals in the United States each year with over 50% of these deaths occurring in Newborn Intensive Care Units (NICU). NICU nurses are frequently involved in end-of-life (EOL) care and face unique obstacles. Objective: The objective of this study was to obtain NICU nurses suggestions for improving obstacles in EOL care in NICUs. Methods: Suggestions were obtained through mailed survey research in qualitative study design. Returned surveys yielded 121 nurse respondents who gave a total of 138 suggestions.Results: A total of 10 cohesive themes were identified: (1) environmental design issues, (2) improved communication …

How Is Chaplaincy Marginalised-By Our Faith Communities And By Our Institutions And Can We Change It?, Jeffrey Cohen

Medical Papers and Journal Articles

This paper reviews the issues confronting chaplaincy/spiritual care in the 21st century. It looks at how faith communities are changing their view of chaplaincy as well how institutions respond. The paper looks at two qualitative studies and what can be learned from them in confronting the questions raised at the beginning. It concludes with the question of how the evidence base can be expanded to make chaplaincy/spiritual care more relevant over the next few years.

Physician-Assisted Suicide And Euthanasia: Emerging Issues From A Global Perspective, Charles L. Sprung, Margaret Somerville, Lukas Radbruch, Nathalie Steiner Collet, Gunnar Duttge, Jefferson P. Piva, Massimo Antonelli, Daniel P. Sulmasy, Willem Lemmens, E Wesley Ely

Medical Papers and Journal Articles

Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn’t be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and violated, including administering lethal drugs without patient consent, absence of terminal illness, untreated psychiatric diagnoses, and nonreporting; 2. Lack of self-determination: Psychological and social motives characterize requests for PAS-E more than physical symptoms or rational choices; many requests disappear with improved symptom control and psychological support; 3. Inadequate palliative care: Better palliative care makes most patients …

Patient Experiences Of A Physiotherapy-Led Multidisciplinary Rehabilitative Intervention After Successful Treatment For Oesophago-Gastric Cancer, Annemarie Bennett, L. O'Neill, D. Connolly, E. M. Guinan, L. Boland, Suzanne Doyle, J. O'Sullivan, J. V. Reynolds, J. Hussey

Articles

Purpose To qualitatively explore the perceived impact of a 12-week rehabilitative intervention for oesophago-gastric cancer survivors on their physical, mental and social wellbeing. Methods Of the 21 participants who completed the intervention, 19 took part in a semi-structured focus group interview. Four audio-taped focus groups were held, ranging in size from two to eight participants. Focus groups were transcribed and analysed using a descriptive qualitative approach. Results At recruitment, participants were 23.5 ± 15.2 months post-surgery and all had suboptimal fitness levels. Participants reported improvements in their physical capacity and ability to carry out activities of daily living during the …

Improving Nurses' Proficiency And Confidence In The Use Of Aromatherapy For Patients In The Hospice Setting, Erika Bigwood-Keaton

Master's Projects and Capstones

The Institute of Medicine noted patient centered care as one of the six priority areas of improvement for the U.S. healthcare system. Recognizing that patients in hospice require specialized care to address the physical, emotional and spiritual needs that are associated with a terminal illness, the focus of this project is to improve the hospice nurses’ knowledge of and confidence in the use of aromatherapy for symptom management. There is recognition within the field of healthcare that patients are interested in having options for treatment. With little to no side effects, aromatherapy has been shown to be an effective alternative …

Individualized Glycemic Targets For The Elderly Residing In Long Term Care Facilities, Abegail Hubberd

Doctor of Nursing Practice

Of people age 65 and older residing in a long-term care facility, 1 in 4 has Type 2 diabetes (Smide & Nygren, 2013). Care and management of this population is a challenge for nurses and other providers. Results of a needs assessment in a local long-term care facility identified deficiencies in the provision of evidence-based Type 2 diabetes care for this target population. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for the elderly residing in long-term care facilities, especially for those with compromises in clinical and functional status. This two prong quality improvement project strove to …

Factors That Influence Self-Reported Health Changes With Caregiving, Margaret Danilovich, Xiaoling Xiang, Daniel Pinto

Physical Therapy Faculty Research and Publications

Objective: This study examined factors associated with the self-reported change in health status as a result of caregiving. Method: Multinomial logistic regression were performed to examine the sociodemographic characteristics, care recipients’ characteristics, and caregiving experiences that affect caregivers’ perceptions of health affected by caregiving using data from 1,087 caregiver respondents in the Caregiving in the U.S. 2015 data set. Data were collected through an online or telephone survey of randomly selected adults in 50 states. Results: Worsened self-reported health with caregiving occurred for caregivers aged 50 to 64, racial/ethnic minorities, those who lived within 20 min of the care recipient’s …

Prisons As Learning Environments For Nursing And Public Health Practice, Mary Bouchaud, Phd, Rn, Madeline Brooks

College of Nursing Posters

Background:

Challenges in Securing Community Nursing Rotation Sites Eighteen years of providing clinical placement for Bachelor of Science in Nursing (BSN) students has demonstrated that community-based educational opportunities are shrinking due to:

•Increased regulatory requirements

•Competing numbers of nursing schools

•Increasing student enrollment

•Decreasing availability of community resources capable and willing to precept students

These issues present challenges to preparing students for nursing practice. A college of nursing at an urban, academic health center found a solution by working with unexpected partners – maximum security prisons and juvenile detention centers.

A Novel Solution: Partnerships with Prisons

Several factors make prisons …

A New Understanding Of Palliative Care, Sarah Gale

The University Honors Program

The purpose of this paper is to discuss palliative care and how it is relates to chronic illness. It will include the current problems with palliative care as it is associated with chronic illness. The significance to nursing will be indicated and a review of literature follow and then by a synthesis of the literature. A project proposal will follow the synthesis followed by an evaluation of the implemented project and conclusion.

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

Preparing For The Merit-Based Incentive Payment Structure: A Value-Based Business Plan, Ali R. Saheb

Doctoral Projects

The notion of delivering value-based care while maintaining corporate vitality in health care is a multifaceted process. Shaping a business model to reflect this process requires the alignment of quality implications, reimbursement initiatives, a framework that takes into account stipulations on reimbursement for different types of clinicians, and an understanding and preparedness for emerging guidelines and nationally recognized structures for quality indicators. When organizations recognize the need for change, but are not yet prepared to implement it, a comprehensive business plan can help the organization visualize a path to success. In this project, the foundation of requirements for a value-based …

End Of Life Care Practices For Patients Who Die In Intensive Care Units (Icu), Jila Ghabeljoo

Doctoral Projects

Today, one in five hospital deaths happens in the intensive care unit with the expectation of twice as many by 2030. Increasing, mortality has triggered a growing attention to end-of-life (EOL) care in the ICU. However, the lack of coveted EOL and palliative care skills creates a challenge for ICU nurses. The aim of this study was to assess the current practices of EOL care in the ICU. In this quantitative research, a retrospective chart review method was employed to analyze the collected data from a population 60 EOL patients who died in the ICU of a Southern California hospital. …

Hospice And Palliative Care: Imperative To The Education Of Nursing, Crystal Lynn Jordan

Nursing Theses and Capstone Projects

Many advanced practice nursing programs do not have hospice and palliative care content included in their curricula. Reviewing the literature regarding the nature of hospice and palliative care content in advanced practice nursing curricula revealed few published studies. Rather than a small snapshot of what end-of-life care entails, it is vital to integrate end-of-life care into every aspect taught in advance practice nursing school. The purpose of this thesis was ascertain the nature of hospice and palliative care content contained in advanced practice nursing curricula. A survey was sent to advance practice nursing program directors asking for information related to …

A Systematic Review - The Effect Of Hospice And Palliative Care, Justin M. Brown, David J. Havener, Jeffrey T. Byrne

Williams Honors College, Honors Research Projects

Many older adults nearing death experience unnecessarily invasive and costly healthcare treatments, often causing more harm than good. Hospice and palliative care interventions offer a possible solution to this problem by prioritizing high-quality and cost-effective care with a strong focus on comfort and satisfaction. The authors of this paper seek to answer the following question: Do hospice and palliative care interventions directed toward older adults at the end of life improve quality of life, cost of care, and satisfaction? This paper thoroughly reviews and critically appraises existing research related to the effect of hospice and palliative care directed toward older …

Mhealth In Palliative Care For Cancer Patients & Care Givers, Newton Andebe, Peter Waiganjo, John Weru

Internal Medicine, East Africa

Patients and caregivers in palliative care experience multidimensional pain. In current practice, information about a cancer patient progress is known when they visit a clinic or make a distress call when their conditions worsen. This strategy is not efficient for systematic monitoring of symptoms, which is key in improving palliative care. Mobile phones have helped to transform healthcare through diagnosis, health education and symptoms management of chronic illnesses. In this study, a mobile phone assessment tool was implemented at an outpatient palliative care clinic for cancer patients in Aga Khan University Hospital, Nairobi. The usefulness of the mobile phone application …

Managing 'Shades Of Grey': A Focus Group Study Exploring Community-Dwellers’ Views On Advance Care Planning In Older People, N Michael, C O'Callaghan, E Sayers

Medical Papers and Journal Articles

Background: Community-dwelling consumers of healthcare are increasing, many aging with life-limiting conditions and deteriorating cognition. However, few have had advance care planning discussions or completed documentation to ensure future care preferences are acted upon. This study examines the awareness, attitudes, and experiences of advance care planning amongst older people and unrelated offspring/caregivers of older people residing in the community.

Methods: Qualitative descriptive research, which included focus groups with older people (55+ years) and older people’s offspring/caregivers living in an Australian city and surrounding rural region. Data was analysed using an inductive and comparative approach. Sampling was both convenience and purposive. …

“Life Within The Person Comes To The Fore”: Pastoral Workers’ Practice Wisdom On Using Arts In Palliative Care, Clare O'Callaghan, Libby Byrne, Eleni Cokalis, David Glenister, Margaret Santilli, Rose Clark, Therese Mccarthy, Natasha Michael

Medical Papers and Journal Articles

Background: Pastoral care (also chaplaincy, spiritual care) assists people to find meaning, personal resources, and connection with self, others, and/or a higher power. Although essential in palliative care, there remains limited examination of what pastoral workers do. This study examined how pastoral workers use and consider the usefulness of art-based modalities.

Methods: Qualitative research was used to examine the practice wisdom (tacit practice knowledge) of pastoral workers experienced in using visual arts and music in palliative care. Two focus groups were conducted. Thematic analysis was informed by grounded theory.

Results: Six pastoral workers shared information. Three themes emerged. First, pastoral …

Family Communication Concerning End-Of-Life Care Preferences, Lindsay Jo Peterson

USF Tampa Graduate Theses and Dissertations

Communication concerning the care one wishes to receive at the end of life (EOL) is central to ensuring that wishes are honored. Many studies have examined doctor-patient or doctor-family EOL communication. However, relatively few studies have focused on the occurrence of EOL care discussions among family members. This is an important topic, as research suggests that advance directives (ADs) are ineffective if patients have not involved surrogate decision-makers, most of whom are family members. This study examined EOL care discussions among family members. It used quantitative and qualitative data from a diverse sample of older adults from West Central Florida …

The Perception For Good Death Of Community Dwelling Japanese And Thailand Respondents, Michiyo Ando, Supawadee Somchit, Mitsunori Miyashita, Laiad Jamjan

Asian/Pacific Island Nursing Journal

Having a “good death” is a very important goal of palliative care, and it is useful for nurses to understand cultural differences in the perception of a good death to propose nursing care. The purpose of this study was to compare the perception of a “good death” among community-dwelling Japanese and Thai people. Three hundred sixty-nine respondents completed the Good Death Questionnaire. The research design was a cross-sectional study. The scores of the Japanese respondents on “good relationships with medical staff,” “being respected as an individual,” and “fighting against cancer” were higher among Thai respondents. On the other hand, “environmental …

Gw Nursing, Fall 2016, George Washington University, School Of Nursing

GW Nursing Magazine

No abstract provided.

Exploring The Relationship Between And Among Registered Nurses' Spiritual Well-Being, Spiritual Care Perspectives, And Their Provision Of Spiritual Care In Acute Care Settings, Barbara J. Kitchener

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Despite acknowledgment that spiritual care is an essential aspect of holistic nursing care, nurses often feel ill-prepared for, uncomfortable with, and uncertain about providing spiritual care. Studies have indicated that nurses who have a strong sense of their own spiritual well-being and/or a positive perspective [attitude, value, belief] about spiritual care are more inclined to provide spiritual care to their patients. However there is a scarcity of such studies among acute care nurses. This descriptive correlational study aimed to explore relationships between and among acute care nurses’ spiritual well-being (SWB), spiritual care perspectives (SCP), and their provision of spiritual …