Digital Commons Network^™

The Integration Of Catholic Mission And Ethics In Contributing To A Good Death, Noah Dimas

Electronic Theses and Dissertations

Catholic healthcare ethics exists within a morality that is under regular heavy scrutiny. This is furthered by the healthcare space itself becoming more secular as the greater society itself moves beyond the religious origins of healthcare. However, this does not have to be relegated to a negative. Rather, this can become a strong call to action for Catholic healthcare to rally together and advocate for itself in the wider healthcare space. This is especially true as these challenges to the Catholic moral-ethical framework begin to question the presence of both Catholic and religious healthcare as whole. These challenges, if left …

The Ethics Of Governance Of Data Analytics In Healthcare, Andrew Harrington

Electronic Theses and Dissertations

Recent literature and studies on data governance usually focus on data ethics and governance from a specific country or industry, which has been mostly business, without considering the larger global impact that is affected. Data is a worldwide asset; thus, its implications and considerations should be viewed as such. Hence, this dissertation attempts to incorporate this view by weaving together topics in healthcare, such as the blending of finance and delivery, data governance at the micro and macro levels, data analytics in healthcare, ethics of AI and information management, and technology’s impact on end-of-life practices. Through highlighting these areas of …

“We’Re Dealing With An Inhumane Lack Of Resources”: Provider Perspectives On Palliative And End-Of-Life Care For Adults Experiencing Homelessness, M. Pilar Ingle

Electronic Theses and Dissertations

Although palliative and end-of-life (PEOL) care offer many benefits to individuals with life-limiting illness, unhoused individuals face barriers in accessing these forms of care. Despite calls over the last several decades to improve PEOL services for unhoused individuals, this population remains underprioritized in efforts to improve access to healthcare. A richer understanding of these inequities as they relate to the specific social and political contexts within a state, such as Colorado, may offer more direct guidance on opportunities to improve policy and care provision.

The purpose of this study was to explore healthcare and social service provider-identified approaches and challenges …

Clinical Pharmacy Services And Medication Utilization In Hospice Care, Aishwarya Kulkarni

Electronic Theses and Dissertations

Background: As discussed within the guidelines from the American Society of Health-System Pharmacists (ASHP), pharmacists are an integral part of the hospice multidisciplinary team involved in optimizing the treatments. Methadone, a long-active opioid, is particularly useful in this population but may be clinically underutilized. Additionally, the cost share of medication utilization in hospice and palliative care is shifting towards hospice providers. The assessment of medication utilization and methadone use in this setting can help develop overall cost/clinical optimization strategies. Thus, there is a need to understand the use and expenditure of various medications and pharmacists' role in providing methadone …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Cultural Aspects Of End Of Life Advance Care Planning For African Americans: An Ethnonursing Study, John Collins

Electronic Theses and Dissertations

Introduction: Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are impacted by demographic variables, cultural distinctives related to patient autonomy, mistrust of the healthcare system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. End of Life (EOL) advance care planning (ACP) promotes patient and family centered care. The purpose of this study was to identify culturally based meanings, expressions, and traditions of EOL ACP and decision making among African Americans, to better understand and provide culturally congruent nursing …

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

Electronic Theses and Dissertations

Objective. The objective of this study was to explore nursing students’ spirituality, religiosity, and perceived ability to provide spiritual care. Background. Nursing students must be prepared to respond to a patient’s spiritual needs. A gap in knowledge exists as to the educational preparedness necessary to provide a nursing student with the ability to respond to a patient’s spiritual need. To address the gap, this study explored the relationships between nursing students’ spirituality, religiosity, and perceived ability to provide spiritual care. Study Setting and Sample. This multi-site study used two accredited nursing programs located in the Western Region of the United …

An Ethical Argument For A Specific Model Of Palliative Care In Nigeria, Dozie Egbe

Electronic Theses and Dissertations

The need for palliative care in Nigeria is huge. But Nigeria has minimal palliative care activity that does not correspond to the great palliative care needs in the country. The great needs are heightened by poverty and poverty induced conditions. However, Nigeria has untapped sociocultural values that can boast palliative care in the country. Such values can be activated and constructively integrated in the practice of palliative care in Nigeria.

This project looks back to what palliative care has been in history and in developed nations to argue for a constructive and positive manner palliative care can evolve in Nigeria …

The Development Of A New Model For Assessing African-American Spirituality In Palliative Care, John C. Welch

Electronic Theses and Dissertations

Research has shown that African-Americans are least likely to receive adequate palliative interventions leading to concerns about the quality of health care in general and palliative care in particular for this population. Acknowledging patient preferences are essential in administering quality health care especially when a patient's condition is terminal. But when African-Americans are least likely to complete living wills or durable power of attorneys for health care and more likely to continue to request life sustaining treatments when near death, conflicts between patients and medical professionals can result.

Recognizing patient spirituality and addressing their spiritual needs can help the patient, …

Medication Cost And Utilization In Hospice Care: An Analysis Of 2007 Claims Data, Rachi Parekh

Electronic Theses and Dissertations

Objectives:

1. Describe patient-related and hospice-related characteristics such as gender, average length of hospice stay, primary diagnoses, average daily census, number of admissions per year, net operating revenues, inpatient unit (IPU) operating costs, and medication expenditures of hospices in Ohio and compare it with NHPCO data.

2. Identify and analyze therapeutic drug classes and medications with the most frequent utilization rates and largest percentage of expenditures in hospice care.

Method:

Hospice Pharmacy Benefit Managers (PBM) employ pharmacists to provide comprehensive pharmaceutical care services for patients under hospice care and one component of pharmacist provided services include comprehensive medication review. To …