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Rompiendo Fronteras: Addressing Language Barriers In Hispanic Palliative Cancer Care, Carla Mcnulty, Catherine Finlayson

International Nursing Research Congress (INRC)

Background: Cancer is the leading cause of death among Hispanic people, accounting for 20% of deaths (American Cancer Society, 2023). In 2024, the American Cancer Society predicted that 195,300 Hispanics would be diagnosed with cancer in the United States, and 50,400 (25%) would die from their disease, leaving approximately 144,900 (75%) living with cancer. As the Hispanic population rises in the United States, one can predict that cancer diagnoses will also increase. This is likely to result in a higher number of cancer-related deaths, as well as more individuals living with cancer. Consequently, there will be an increased demand for …

Factors Influencing Pediatric Palliative Care Utilization: A 12-Year Retrospective Study In Taiwan, Tzu-Ying Yang, Wei-Wen Wu, Frank Leigh Lu, Shao-Yi Cheng, Tsung-Hsien Yu, Kristin Berg

International Nursing Research Congress (INRC)

Background and objective: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions and their families by addressing physical, psychological, and spiritual needs. Despite increasing recognition of its benefits, PPC remains underutilized, particularly in Asian contexts where early integration and service accessibility are still limited. This study aimed to examine trends and factors influencing PPC utilization among deceased children in a tertiary children’s hospital in Taiwan from 2012 to 2023, to provide evidence on predictors for more equitable access to PPC.

Methods: A retrospective study was conducted using medical records of children aged 1–18 years who …

Breaking Down Barriers To Pediatric Respite Care Use, Michelle Montanez

Group: Northern Arizona University School of Nursing, DNP Doctoral Papers

Parents of children with a life-limiting illness provide constant, around-the-clock care, often leaving little time for their well-being. This responsibility is emotionally, mentally, and physically demanding, and without proper support, parents face increased risk of depression, burnout, and deteriorating health. Respite services offer relief by providing a much-needed break and allowing parents the opportunity for self-care and improved well-being. Though the benefits of respite are well documented, these services remain underutilized due to barriers such as limited provider awareness, lack of access, and emotional challenges the parents face. This Doctor of Nursing Practice (DNP) project aims to address these barriers …

Culturally Diverse End-Of-Life Simulation And Perceptions In Undergraduate Nursing Students, Jodi Kay Olson, Mary Pesch, Julie Keller-Dornbusch

Biennial Convention (CONV)

End-of-life (EOL) patient care is a challenging reality that nearly all nurses will face during their careers. Preparing nursing students for these situations can alleviate anxieties related to patient death (Venkatasalu et al., 2015). Simulation-based learning is an effective approach for teaching complex scenarios like EOL care (Cannity et al., 2021), with numerous studies highlighting improved confidence and competence in students who participate in EOL simulations (Gillan et al., 2014; Tamaki et al., 2019; Venkatasalu et al., 2015; Lewis et al., 2016; Jablonski et al., 2020). However, the lack of cross-cultural variations in death and dying highlights the need for …

Integration Of Infection Management In Physician Orders For Life-Sustaining Treatment (Polst), Aluem Tark

Leadership Connection

Physician Orders for Life-Sustaining Treatment (POLST) is an advanced care planning tool which aims to facilitate End-of-Life communication between a dying patient and medical providers. Our research team examined the status of POLST program implementation across U.S. and identified state-level variations in how infection management is captured in POLST forms.

Impact Of Hemoglobin A1c Screening Program Among Medicare Patients, Mary Jo Quinn, Susan Schaffer

Leadership Connection

In 2016, HouseCalls began conducting point-of-care hemoglobin A1c screening as part of an annual preventative home visit program for patients covered under one Medicare Advantage health plan. This retrospective study (n = 34,348) evaluated the impact of this intervention on the following year's body mass index and hemoglobin A1c.

Examining Dnar Status In Pediatric Palliative Surgical Patients: An Application Of A Decision Analysis Tool, Margaret H. Hartig

Leadership Connection

Pediatric palliative care (PPC) involves a multidisciplinary approach for the improved quality of life of children with life-limiting conditions. Many PPC patients present for palliative surgery, which involves procedures that manage symptoms but include risks that could result in catastrophic perioperative events. Determining a patient's and family's wishes regarding do-not-attempt-resuscitation (DNAR) order status can be a difficult topic to broach for providers who encounter these patients for the first time during the preoperative evaluation. A decision analysis tool may help in determining the need for preoperative DNAR communication.

End Of Life In African American Older Adults: An Integrative Literature Review, Karen O. Moss, Karen M. Rose

Leadership Connection

Session presented on Friday, September 26, 2014:

End-of-life care in the United States is described as deficient and fragmented. Minority populations engage in end-of-life planning less frequently than Caucasians. African Americans represent the second largest minority group in the United States with its older adult population projected to increase by 114% by 2030. The Patient-Self Determination Act of 1990 requires Medicare and Medicaid funded healthcare organizations to empower patients to refuse or accept medical care and execute advance directives. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) confirmed substantial shortcomings of healthcare for seriously …

Effect Of A Multimodal Intervention On Advance Directive Completion Rates, Maria B. Douthett

Group: Nebraska Methodist College

Advance care planning (ACP) could be working better both in the primary and hospital settings. When a patient is admitted in the hospital, there are several questions asked during admission regarding ACP but little screening on ACP is done in the primary care setting. Existing research supports ACP as a benefit to quality of death and health care costs, however, there is limited research on how to apply it in the primary care setting. Most of the research regarding ACP and end-of-life (EOL) care focuses on the process in the hospital or in nursing homes.

The goal of this project …

Advance Directive Protocol In The Primary Care Setting, Alexei Boettcher

Group: Nebraska Methodist College

Background and Review of Literature: Advance directives (AD) are documents that offer patients a way to avoid unwanted care in the event of a serious illness or incapacity. Studies demonstrate the care patients receive at the end-of-life is not often consistent with their preferences, as a result of suboptimal communication between the patient and provider as well as documentation of health care proxies and treatment preferences (Isaac & Curtis, 2016). The lack of a current formal protocol used by primary care providers regarding ADs, particularly towards the young adult patient population, resulting in insufficient discussions of patients’ wishes regarding end-of-life …

Culturally Competent Care At The End Of Life- A Hindu Perspective, Sujatha Shanmugasundaram, Margaret O'Connor, Ken Sellick

General Submissions: Clinical Settings Materials

Knowledge of particular cultural requirements is especially important in times of transition such as at the end of life, where issues of death and dying require great sensitivity to cultural and religious differences. Healthcare professionals need to understand different cultures and deliver care accordingly. This article explores the cultural aspects of end of life care among Hindus who live in places other than India and is based on a study of Hindus in Australia. The purpose of this study was to investigate the experience of families of terminally ill Indian patients. This article will explore aspects of the Hindu faith …

A Novel Use Of Social Network Analysis And Routinely Collected Data To Uncover Care Coordination Processes For Patients With Heart Failure, Sijia Wei

Dissertations

Effective patient care transitions require consideration of the patient's social and clinical contexts, yet how these factors relate to the processes in care coordination remains poorly described. This dissertation aimed to describe provider networks and clinical care and social contexts involved during longitudinal care transitions across settings. The overall purpose of this dissertation is to uncover the longitudinal patterns of utilization and relational processes needed for effective care coordination in transitional care, so we can redesign interventions that focus on informational and relationship networks to improve interaction patterns and system performance for people living with heart failure (HF) as they …

[Excerpt From] Anatomy Of Writing For Publication For Nurses (5th Ed.), Cynthia Saver

Sigma Publications: Book Excerpts

This item record pertains to an excerpt from Anatomy of Writing for Publication for Nurses, 5th Edition, which is provided free of charge by the publisher.

About this book:

If you need to make the leap from single sentences to a published manuscript, you will find valuable help and resources in this fully updated fifth edition of Anatomy of Writing for Publication for Nurses.

In this practical and useful guide, lead author and editor Cynthia Saver removes the fear and confusion surrounding the writing and publishing process. Along the way, 25 of nursing's top writing experts and decision-makers …

Spirituality, Religiosity, And Perceived Ability To Provide Spiritual Care In Nursing Students, Shannon O'Connell-Persaud

Dissertations

The objective of this study was to explore nursing students' spirituality, religiosity, and perceived ability to provide spiritual care.

[Excerpt From] Hospice & Palliative Care Handbook: Quality, Compliance, And Reimbursement (4th Ed.), Tina M. Marrelli, Jennifer Kennedy

Sigma Publications: Book Excerpts

This item record pertains to an excerpt and additional resources from Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, Fourth Edition, which is provided free of charge by the publisher.

About this book: Hospice & Palliative Care Handbook, 4th Ed., offers updated coverage of all aspects of hospice and palliative care for the entire healthcare team who provide important care while meeting difficult multilevel regulations. This edition includes examples and strategies covering key topics related to standards, guidelines, goals, and effective care planning.

New to this edition are:

• Expanded pediatric and geriatric clinical care guidelines
• More robust …

Parents/Caregiver's Health, Stress, And Perceived Caregiver Burden In The Difficult First 3 Months After Their Infant/Child With Special Health Care Needs Is Discharged Home, Carmen Caicedo

Sigma Foundation for Nursing Research Grant Reports

The purpose of this exploratory study with three time points will examine the physical health, mental health, stress using biomarker levels (salivary cortisol), and perceived caregiver burden of Hispanic, Black, and White parents of an infant/child (birth to 5 years) newly diagnosed with special health care needs (SHCN) over the first three months after discharge home from a NICU or PICU.

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care.

Improving End Of Life Care: Symptom Assessment And Education For Informal Hospice Caregivers (A Quality Improvement Project), Erika Buchholz

DNP and Student Works

In the setting of COVID-19, more individuals experience the dying process in their home rather than at hospice facilities. Currently, there are limited resources to help informal caregivers identify signs and symptoms of death and dying. The Edmonton Symptom Assessment System (ESAS) is a standardized assessment tool that can be offered in the hospice setting. This quality improvement (QI) project aims to increase utilization of the ESAS tool among caregivers with loved ones enrolled in hospice.

Nursing And Midwifery Links [June 2021 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

In this June edition, all regions of the Collaborating Centers are represented with insight into the global health experience as Nurses, Midwives, Students, and Educators over the past six months. Progressive programs for better supporting the dedicated Nurse are explored. Our international colleagues are celebrated and honored; as well as mourned. In honor of those who lost their lives during the Covid Pandemic, and those who continue to forge on in the face of loss, we offer a heartfelt representation of solidarity in the form of voices from Collaborating Centers across the globe, from our community to yours.

A Proactive Approach To Bladder And Bowel Management In Adults (4th Ed.), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This best practice guideline (BPG) focuses on bladder and bowel management in adults (aged 18 years and older). In particular, this BPG provides evidence-based recommendations for effective strategies to support adults who live with urinary incontinence, fecal incontinence and/or constipation that will improve quality of care and lead to positive health outcomes.

For more information including supplementary documents and translated versions visit: https://rnao.ca/bpg/guidelines/proactive-approach-bladder-and-bowel-management-adults

An Educational Initiative To Prevent Unnecessary Hospitalization For Hospice Patients, Alkeisha H. Mims

Dissertations

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose …

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

Dissertations

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 care …

Nursing And Midwifery Links [December 2020 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

As a historic year comes to a close, this edition of the Links Magazine will serve as a reflection of the incredible innovation and fortitude shown by our colleagues worldwide. For perhaps the first time in many, many years, 2020 was the year that humanity shared the experience of a common event of global proportions. Healthcare was placed front and center as the world watched from where they were sheltered in place. From varying cultures and perspectives, the nurses and midwives of the world were presented with a deadly challenge that came on quickly, and continues to plague many countries. …

Caregiver Comfort With Tele-Hospice, Patricia L. Cameron

International Nursing Research Congress (INRC)

Tele-hospice is changing the provision of on-demand hospice and palliative care. A retrospective, descriptive study was completed examining comfort and emotional support that caregivers of community-based hospice patients derived from using electronic tablets. 667 survey responses were obtained. Data analysis included Pearson product moment correlations and Wilcoxon signed ranks tests.

Nursing And Midwifery Links [June 2020 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

A warm welcome to the June edition of the Links Magazine 2020. As this is the Year of the Nurse and Midwife, for this edition we did something a little different. For the past year, we have connected with nurses and midwives in various parts of the world to document not only their daily impact on the community around them, but also how their careers have been shaped by the COVID-19 pandemic. You will see their responses at each time point, in addition to some background information about these respected colleagues.

The Experience Of Being Discharged From Hospice Alive As Perceived By Patients, Their Spouses, And Adult Children, Rebeka Bianca Campbell

Dissertations

Approximately 1.56 million patients received hospice care in 2009, and 243,000 individuals were discharged alive (NHPCO, 2010). There is a paucity of research describing the experiences of individuals discharged from hospice alive. The purpose of this transcendental phenomenological study was to explore the experiences of adult individuals with a life-limiting condition who were discharged from a hospice program due to decertification related to ineligibility or extended prognosis from the perspective of the individual and his or her adult family members. The study's research questions were: (a) how do participants perceive and describe the experience of being discharged alive from hospice, …

Providing Hospice Care For Children: An Organizational Study, Lisa C. Lindley

Dissertations

Background. Of the 54,000 children, who die in the US, many lack access to hospice care. As terminally ill children increasingly return home to die, little is known about the hospices that provide care for children and what factors may influence whether care is provided. Objective. To understand the institutional and resource factors that may influence the provision of hospice care for children, while controlling for organizational and market factors. Methods. This study used a retrospective, longitudinal design.

Development Of A Program Proposal For A Nitrous Oxide Program In Pediatrics, Sarah Ann Oleson

Dissertations

When pediatric patients are admitted to the inpatient or outpatient hospital setting they potentially have to endure procedures that cause pain, fear, and anxiety which can have a lifelong impact on the child's response to future healthcare needs. The purpose of this project was to create a comprehensive program proposal for a nitrous oxide sedation program to minimize those perceptions towards medical procedures. The project utilized a systematic review of literature and secondary data to address the most important indicators for developing a comprehensive program proposal to present to the pediatric leadership team. Multiple studies have shown nitrous oxide having …

Perceptions Of Future And Advance Care Planning For Japanese Women With Early Stage Gynecological And Breast Cancer, Yuki Asakura

Dissertations

Advance care planning (ACP) is the process that allows individuals to choose a path of care in the event that they are unable to make a decision for themselves. The concept of advance care planning is much broader than merely putting wishes in writing; however, misconceptions exist. The purpose of this study was to gain understanding of perceptions of Japanese women with early stage cancer about ACP. A theoretical model for ACP was developed from review of current knowledge. This study was significant to developing culturally sensitive intervention in supporting ACP in this Asian population. This study utilized ethnography guided …

A Palliative Approach To Care In The Last 12 Months Of Life, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This best practice guideline (BPG) provides evidence-based recommendations to nurses and the interprofessional health team who support adults experiencing the last 12 months of a progressive life-limiting illness, and their families and caregivers. The goals of the recommendations are to:

• improve delivery of psychosocial, spiritual and culturally safe care
• enhance co-ordination of care
• facilitate supportive work environments

The BPG applies to all practice settings in which people require palliative care and end-of-life care services (for example, acute care, community care, long-term care). Specifically, this BPG will focus on persons experiencing the last 12 months of progressive life-limiting illness and their …