Digital Commons Network^™

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 …

Faith And/In Medicine: Religious And Conscientious Objections To Maid, Daphne Gilbert

Dalhousie Law Journal

Across Canada, health care institutions that operate under the umbrella of religious traditions refuse to offer medical assistance in dying (MAiD) on the grounds that it violates their Charter-protected rights to freedom of religion and conscience. This article analyses the Supreme Court jurisprudence on section 2(a) and concludes that it should not extend to the protection of institutional rights. While the Court has not definitively pronounced a view on this matter, its jurisprudence suggests that any institutional right to freedom of religion would not extend to decisions on publicly-funded and legal health care. MAiD is a constitutionally-protected option for individuals …

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. …

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 …

Aid In Dying In Montana: Ten Years After State V. Baxter, Kathryn L. Tucker

Montana Law Review

No abstract provided.

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.

A Review Of Chemotherapy And Radiotherapy Near The End Of Life In Individuals With Metastatic Non-Small Cell Lung Cancer, Benjamin C. Li, Stephanie M. Perkins, Sharon E. Phillips, Sara F. Martin, Samantha Hsieh, Eric T. Shinohara, Mark J. Stavas

Open Access Publications

No abstract provided.

The Influence Of Military Service Experiences On Current And Daily Drinking, Andrew S. London, Janet M. Wilmoth, William J. Oliver, Jessica A. Hausauer

Population Health Research Brief Series

Traumatic military service experience can lead to increased alcohol consumption among veterans, who may use alcohol as a form of self-medication. Veterans with a psychiatric disorder or traumatic brain injury are more likely than nonveterans to be daily drinkers. Non-combat and combat veterans without a PD or TBI are less likely than nonveterans to be daily drinkers.

Consider Palliative Care: A Decision Aid To Improve Palliative Care Knowledge, Meg Schultheiss

Yale School of Medicine Physician Associate Program Theses

Palliative care enhances a patient’s quality of life by managing symptoms and psychosocial needs and facilitating advanced care planning. Engagement with palliative care improves satisfaction with care in patients and the informal caregivers identified by patients. However, palliative care is underutilized because many patients and their informal caregivers have limited knowledge about palliative care. Decision aids effectively educate patients and informal caregivers in a variety of clinical settings. We propose a randomized clinical trial that will test the effectiveness of a decision aid for informal caregivers considering palliative care. Specifically, we will match informal caregivers to a decision aid and …

2020-2021 Pediatric Subspecialty Trainees, Children's Mercy Hospital

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in adolescent medicine, allergy/immunology, child abuse pediatrics, child neurology, coagulation, congenital cardiac surgery; clinical child psychology, developmental-behavioral pediatrics, epilepsy, headache medicine, hospice & palliative care, laboratory genetics & genomics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric bioethics, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric EM/child abuse, pediatric dermatology, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric readiology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, pharmacy, pediatric residency and med/peds residency

Unm Global Health Covid-19 Practice Guidelines, Unm Global Health Covid-19 Briefing Team

HSC Covid 19 Briefings

No abstract provided.

Benefits Of Palliative Care In The Intensive Care Unit, Stephen Swenson, Stephen M. Swenson

Nursing Masters Papers

Abstract

The use of palliative care is often overlooked until the terminal phase of serious illness when life-prolonging interventions are deemed futile and death is considered imminent.

Alongside the well regarded Clinical Practice Guidelines for Quality Palliative Care (National Coalition for Hospice and Palliative Care, 2018), numerous critical care societies including the American Association of Critical-Care Nurses (Medina & Puntillo, 2006), American College of Critical Care Medicine (Davidson et al., 2008), American College of Chest Physicians (Selecky et al., 2005), American College of Surgeons (2017), and the American Thoracic Society (Lanken et al., 2007) have each published individual policies highlighting …

Palliative Care Challenges And Strategies For The Management Amid Covid-19 Pandemic In India: Perspectives Of Palliative Care Nurses, Cancer Patients, And Caregivers, Radhika Pai, Malathi Nayak, N. Sangeetha

Open Access archive

The WHO selected 2020 to recognize the work of nurses and midwives because it is the bicentenary of the birth of the founder of modern nursing, Florence Nightingale. It has been demonstrated amply now as the nurses are the largest sector of health-care workers in every country, playing a pivotal role in response to the novel coronavirus (COVID-19) pandemic worldwide. Every day, nurses are working tirelessly by leaving their homes to assist the sick, allay community fears, and address concerns. This article is written by interviewing the staff nurses working in the wards/outpatient departments of a reputed palliative care center …

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.

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …

Adoption Of Macy Catheter By Aurora At Home Hospice Staff: A Quality Improvement Evaluation Study, Patrick Herson, Kavita Sharma, Kristi Barfield, Nora Clapsaddle

Aurora Hospice/Palliative Medicine Fellows

Background: The Macy Catheter (MC) is a tool to aid rectal delivery of oral medications in microenemas. In 2019, Aurora Health at Home hospice chose the MC as a preferred route for delivery of medications when patients no longer tolerate the oral route. Despite training, adoption of the MC has been slow.

Purpose: To determine what barriers exist to faster adoption and utilization of the MC by hospice nursing staff. It is anticipated that once the barriers are identified they will be addressed through a campaign of quality improvement projects with subsequent monitoring of adoption.

Methods: An anonymous survey was …

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 …

Metric Analysis Of Literature In The Field Of Community Health Nursing (1999 – 2018), Jagannathan Ramakrishnan Dr, Jayaraman Selvamani Dr, Kotti Thavamani Dr

Library Philosophy and Practice (e-journal)

This paper presents a metric analysis of Community Health Nursing, the records published during the year 1999 to 2018 in the MEDLINE data which are covered in the Pubmed. It is noticed that from 1999 onwards there is a gradual increase except for some years and also observed that a total of 39140 records in the field of Community Health Nursing. It was found that 51.78% was journal articles, 21.79% was Research Support, Non U.S. Gov't and 9.07% was Review. English language (95.56%)is dominated in almost all the countries irrespective of the native language of the country. This is followed …

The Effect Of The Timing Of A Hospice Referral And The Perceived Quality Of Care By The Family, Caitlin Tran

Nursing | Senior Theses

Hospice care is a specialized type of palliative care for patients with a time-limiting illness. Despite its benefits, hospice remains underutilized. A key reason behind the underutilization are untimely referrals, often made during the last weeks or days of the patient’s life. The purpose of this paper is to investigate the existing barriers towards hospice that play into late referrals and its effect on patient/family satisfaction. This information will be examined to propose a pilot research study for further exploration.

Final Opportunities For Healthcare Chaplains To Share The Gospel To Those Facing End Of Life, Michal Lynn Lee

Masters Theses

Spiritual care is a necessity for end-of-life care. Those with terminal illnesses and facing death are concerned about things of spiritual or existential nature. The National Consensus Project for Quality Palliative Care study indicated that most patients want to have their spiritual concerns addressed, and yet, spiritual concerns are not adequately addressed with the medical team and the current system of care. This paper builds on the role of the chaplain within a healthcare context for those facing end-of-life scenarios and reinforces the impact of the chaplain to fulfill his primary role of addressing eternal issues. Healthcare chaplains enter the …

Santa Cruz Hospice: Transitions And Palliative Care Services Pilot Volunteer Program, Renalyn Mae Serrano

Capstone Projects and Master's Theses

Hospice of Santa Cruz County is regarded as the most experienced hospice program in the region. Currently, terminally ill patients who are not enrolled in any type of hospice care program are not receiving resources for services soon enough. Also, the transitions and palliative care patients at Hospice aren’t receiving adequate social or emotional support. This project piloted a Transitions and Palliative Care Services Volunteer Program with volunteers providing direct services through biweekly or monthly visits to patients that included companionship, emotional support and cognitively stimulating activities. The direct service of volunteer visits was used in order to increase patient …

Effect Of A Pharmacist-Led Antimicrobial Stewardship (Ams) Program On Outpatient Fluoroquinolone Prescribing In The Elderly, Katie Larue, Chelsea Mannebach, Bonnie Jiron

Providence Pharmacy PGY2 Program at Providence Medical Group 2020

Title: Effect of a pharmacist-led antimicrobial stewardship (AMS) program on outpatient fluoroquinolone prescribing in the elderly

Authors: LaRue, Katie PharmD; Mannebach, Chelsea PharmD, BCPS, BCACP; Jiron, Bonnie, PharmD, BCACP

Introduction: The Center for Disease Control and Prevention, the Society of Infectious Diseases Pharmacists, and American Pharmacists Association recognize the need for outpatient AMS programs and the important role pharmacists play in appropriate prescribing. Fluoroquinolones (FQ) pose many risks, highlighted by U.S Food and Drug Administration safety warnings, including aortic dissection, hypoglycemia, mental health side effects, and tendonitis, along with the risk of Clostridium difficile infections, particularly in …

Prevalence And Acceptance Of Methadone Recommendations In Hospice And Palliative Care, Aishwarya Kulkarni

Graduate Student Research Symposium

Background:Clinical pharmacists play an important role in the care of patients in hospice/palliative care, particularly for the treatment of pain. Methadone, a long-active opioid, is particularly useful in this population, but may be underutilized. The objective of the study was to evaluate the prevalence ofpharmacist recommendations and subsequent physician acceptance for the use of methadonefor painin newly admitted hospice/palliative care patients. Methods: The study was conductedfrom October-December 2019in coordination with a locally-based pharmacy services organization which works with hospice/palliative care providers. A selectedgroup of pharmacists at the organization identified patients reviewed as new admissions as part of their usual clinical …

2020-04-10 Daily Unm Global Health Covid-19 Briefing, Christophe G. Lambert, Samuel Anyona, Shawn Stoicu, Anastasiya Nestsiarovich, Praveen Kumar, Nicolas Lauve, Evans Raballah, Perez Olewe, Carolyne Ndege, Hannah Groves, Danielle Rivera, Estefania Montanez, Tudor I. Oprea, Orrin Myers, Rachel D. King, Andrew S. Rowland, Kristine Tollestrup, Douglas J. Perkins

HSC Covid 19 Briefings

Executive Summary:

Extra NM HSD SNAP benefits. NM cases >1000. Meds supply chain threatened. Mass graves in NY. Surgeon General screening app. Presidential briefing. Italian healthcare worker deaths. Taiwan tiered care model. Communicating risks to public. French public demand hydroxychloroquine. Vaccination pause dangers. Retesting needed after discharge. CDC report geography and incidence. UW clinical informatics response. UW preparedness guidelines. Wuhan outbreak control. CDC asymptomatic exposed worker guidelines. Mask innovation. Unemployment spikes. Workforce gaps. Workspace modifications reduce transmission. Guidelines and recommendations: ER physician, surgery, cardiopulmonary resuscitation, chest imaging, geriatrics, critically ill children, postpyloric tube placement, genitourinary malignancies, obstetrics, and home work …

Impact Of The Covid-19 Outbreak On Long-Term Care In The United States, Courtney H. Van Houtven, Nathan A. Boucher, Walter D. Dawson

Institute on Aging Publications

The United States (US) currently has the most confirmed cases of COVID-19 of any country. Yet, adequate testing for the virus remains a major issue. Approximately 51.6 million Americans are over the age of 65 and 56 percent of adults over 65 are living with two or more chronic conditions (23 percent have 3 or more). Given the higher risk of death and complications associated with advanced age and underlying health conditions, COVID-19 has had an immense impact upon LTC in the United States. Yet, the level and intensity of impact has been sporadic in application. This is due in …

How Relevant Is The Hippocratic Oath In Guiding Physicians' Views On Physician-Assisted Suicide, Megan Neal

Honors Program: Senior Projects (Public)

The Hippocratic Oath is an ancient vow that most doctors, especially within the last century in the United States, take upon their graduation from medical school. The importance of this oath, however, is up for debate as medical advances and cultural beliefs in the rights of the patient evolve. The Hippocratic Oath has been adapted many times over the past few centuries to reflect the beliefs of the period, but the original Oath still survives. One of the most recent movements in the medicine has been the legalization of physician-assisted suicide (PAS) in select states. Using a qualitative, thematic approach, …