Transdisciplinary Collaboration Of Healthcare Professionals And The Emotional Connectedness With Working With Patients Coping With Death And Dying, Princess Nguyen, Lindsay Gietzen

Pacific Journal of Health

Abstract

Purpose: This study explores how an integrated approach to care for patients and families by transdisciplinary healthcare teams provides opportunities for a patient-centered care approach to support quality of life throughout one's chronic illness and at the end-of-life. Discussions and conversations about impending death or dying are often challenging and a complex task for healthcare professionals in whatever settings. While there is an understanding of aspects of collaborative care and transitions and processes to support patients and families about how to cope and communicate about death and dying, it is essential to recognize how best to support end-of-life care …

The Use Of Art Therapy On Children With Life-Limiting Conditions, Karissa K. Schillinger

Counselor Education Capstones

Art therapy is a growing therapeutic technique that is noninvasive. The present literature review sets out to determine what effect art therapy has on children with life-limiting conditions. This author completed a literature review that involved analyzing ten research studies on a variety of youth populations. Studies were found about children with cancer, a child with cerebral palsy and a child with a severe neurological disorder. Zero incidences of harm were found when using art therapy. However, the literature was complicated by the type of art therapy provided, small sample sizes, varying duration of treatment, lack of control groups, lack …

Exploring Disparities In Palliative Care Utilization For Patients With End-Stage Liver Failure: A Nationwide Cohort Analysis (2016-2020), Sheza Malik, Hajra Khan, Amatul Mueed Taqiyyah Fatima Syeda, Mohammed Faisaluddin, Babu Mohan Md, Asim Mushtaq, Karin Dunnigan

Advances in Clinical Medical Research and Healthcare Delivery

Background: Despite the very high symptom burden, palliative care (PC) services are underutilized in patients with End-stage liver disease (ESLD). Herein, we investigated the disparities in the utilization of PC services among patients with ESLD hospitalized in the United States.

Method: We conducted a retrospective cohort analysis by utilizing the Nationwide Inpatient Sample from 2016 to 2020. All patients greater than 18 years old admitted with ESLD were included in the analysis. A multivariate logistic regression model predicting referral to PC was created.

Results: In our analysis, significant racial disparities were observed in the utilization of palliative care services among …

Measures Of Success: Making The Case For Advanced Practice-Sensitive Quality Indicators, Ruth Kleinpell, April Kapu, Cynthia Borum

HCA Healthcare Journal of Medicine

Advanced practice registered nurses (APRNs) are key health care providers in a variety of settings. Often APRNs are grouped in a collective category, along with physician assistants, and referred to collectively as advanced practice providers. As APRNs assume an increasing role in patient care management in hospital, outpatient, and community settings, such as clinics and rural practices, measuring the impact of their care on patient outcomes and quality of care becomes a necessary component of performance evaluation. APRN-sensitive outcome indicators are an important way to identify the impact of the role. While a number of studies have been conducted that …

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 …

Examining The Relationship Between Ethnocentrism, Perspective-Taking And Cultural Competence In Medical-Surgical Nurses, Lori Ann Palmieri

Seton Hall University Dissertations and Theses (ETDs)

This descriptive correlational study explored the relationships between cultural competence, ethnocentrism, and perspective-taking in practicing medical-surgical nurses living in the United States (US). Participants (N=111) were recruited from the New Jersey Board of Nursing (NJBON) and from the Academy of Medical-Surgical Nurses (AMSN). The survey consisted of three validated instruments a) the cultural competence assessment instrument (CCA-I); b) the generalized ethnocentrism scale (GENE); c) the perspective-taking (PT) subscale of the interpersonal reactivity index (IRI), and d) demographic profile questions. Data were collected via Qualtrics and analyzed with IBM SPSS Statistics (Version 28/29). Ethnocentrism and perspective-taking explained 30.2% of the variance …

Undergraduate Nursing Students’ Simulation Experiences With End-Of-Life Care In A Rural Setting: A Scoping Review, Christopher Norman Msn, Aprn, Gnp-Bc, Jodi Sutherland Phd, Rn, Acrn, Cne, Lori Marie Sprague Phd, Rn, Chse, Deborah Palmer Ms, Rn, Alma Rood Msn, Rn, Laura Lipke Ms, Mlis, Ahip

Nursing Faculty Scholarship

Objective: The purpose of this scoping review is to provide nurse educators and nurse leaders in practice with the findings on the state of the science surrounding undergraduate nursing education simulation-based experiences focused on end-of-life (EOL) care in rural settings. This scoping review aims to identify undergraduate nursing student experiences with EOL care in the rural setting and identify key simulation-based educational strategies utilized in undergraduate nursing programs to inform educational programs about simulation practices. The outcome of this review is intended to advance nursing education to better prepare future nurses for practice and to develop competence in providing EOL …

School Of Nursing Newsletter Fall 2024, Southern Adventist University

Southern Nursing - School of Nursing Newsletter

The Fall 2024 issue of the newsletter features information on the Fall 2023 NCLEX pass rate, Giving Day success, and alumni recognitions.

How Do Older Adults Define A Good Death? A Scoping Review, Ellen L. Csikai, Quentin R. Maynard

Midwest Social Sciences Journal

A scoping literature review of the concepts of ‘good death’ and ‘dying well’ among older adults was conducted. The purpose was to identify aspects that older adults specifically considered important in defining a ‘good death’. The search revealed five articles published between 2005 and 2019 that met inclusionary criteria for the review. Primary among the views of the older adults in these studies of a ‘good death’ was the desire to avoid being a burden to families; done so by dying pain-free/peacefully (preferably in sleep) and preparing in advance by involving family in decisions and funeral/estate planning. Family support throughout …

Cyber Victimization In The Healthcare Industry: Analyzing Offender Motivations And Target Characteristics Through Routine Activities Theory (Rat) And Cyber-Routine Activities Theory (Cyber-Rat), Yashna Praveen, Mijin Kim, Kyung-Shick Choi

International Journal of Cybersecurity Intelligence & Cybercrime

The integration of computer technology in healthcare has revolutionized patient care but has also introduced significant cyber risks. Despite the healthcare sector being a primary target for cyber-attacks, research on the dynamics of these threats and practical solutions remains limited. Understanding the complexities of cyberattacks in this sector is critical, as the impact extends beyond financial losses to directly affect patient care and the protection of sensitive information. This paper applies Routine Activities Theory (RAT) and Cyber Routine Activities Theory (C-RAT) to analyze high-tech cyber victimization case studies in healthcare. The analysis explores the motivations behind these attacks and identifies …

Bridging Education And Service Learning Through Palliative Care, Jamie Borchardt

Journal of Community Engagement and Higher Education

Service learning can bridge the gap between traditional and transformational learning, as students are able to relate the course terminology directly to field experience. This project was set up to determine if volunteering for a semester at Hospice had any effect on emotional intelligence and positivity. A paired samples t-test compared differences in pre- and post-test scores on the Positivity Scale (PS) and the Schutte Self-Report Emotional Intelligence Test (SSEIT). The PS revealed a significant difference in pre- and post-test surveys: t(5)=-2.4, p=.03.

Barriers Primary Care Physician Assistants Face In Referring Patients To Palliative Care Services Early In The Disease Process, Claire Petersen

Theses and Graduate Projects

Background: Medical specialties such as hospice and palliative care have been proven to improve quality of life for patients facing end-of-life and chronic illness. Though increasing awareness of these specialties has resulted in greater availability, it is essential to investigate the barriers clinicians, such as Physician Assistants, face in making these referrals in order to provide quality healthcare to those who need it. Physician Assistants specifically are an essential clinician group to evaluate, as they continue to become more prevalent in the healthcare system.

Purpose: To determine barriers primary care Physician Assistants face when identifying candidates for and referring to …

Increasing Rates Of Advance Directives In Primary Care, Lindsay Shahi

Dissertations

Abstract Problem: Advance directives (ADs) are legal documents which outline one’s medical wishes if they are unable to make such decisions for themselves. ADs have been shown to reduce cost and improve quality-of-life (Starr et al., 2019), (Wright et al., 2008). Only 1/3 of adults in the United States have a completed advance directive (AD) or living will (Yadav et al., 2017). However, 90% of Americans feel it is important to have conversations about end of life, but only 30% have had this conversation (Institute for Healthcare Improvement, 2020). The Five Wishes document addresses decisions at end of life and …

African American Caregivers' Perceptions Of Ecological Factors Related To Hospice Utilization, Monica Prescott Lonon

Walden Dissertations and Doctoral Studies

African Americans remain an underrepresented demographic in hospice care because they underutilize the service at disproportionate rates compared to the total population. The research problem addressed African American perceptions of the microsystem, mesosystem, exosystem, macrosystem, and chronosystem factors that impacted their perceptions and utilization of hospice. The purpose of this generic qualitative study was to explore African American caregivers’ perceptions of environment-related factors that affected their utilization of hospice care. Data were collected from semistructured interviews with 10 African American family caregivers aged 18 and over, with at least 2 years of experience as hospice caregivers. Findings from coding and …

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 …

2024-2025 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in advanced non-invasive imaging, adolescent medicine, allergy/immunology, child abuse pediatrics, child neurology, clinical neuro-psychology, clinical child psychology, clinical child psychology internship, developmental-behavioral, epilepsy, headache medicine, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric EM/child abuse, pediatric infectious diseases, pediatric nephrology, pediatric ophthalmology; pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, …

The Pause: Impacting Moral Distress In Our Caregivers, An Integrative Review, Bethany Corinne Furman

Doctoral Dissertations and Projects

Moral distress is endemic to healthcare in the emerging post-covid era. Moral distress is defined as the knowledge of the correct or ethical action but the repeated inability to act in that manner. First studied in nursing, it has been found in nearly every facet of healthcare and is strongly associated with clinician burnout, intent to leave position, and behaviors that can in turn compromise patient safety. Intensive care unit (ICU) nurses experience moral distress at higher rates than other subspecialties. Prevention of and recovery from moral distress is complex, but various forms of debriefing have long been suggested to …

Ua-Rg08-01 School Of Nursing / Office Of The Dean, Archives

Archives Registers

Self-reports, course syllabi, committee notes, various surveys & reviews, correspondence, announcements, ceremony programs, procedures and policies, 1978-2011

End Of Life, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Improving Quality Of Life And Connection Amongst Pediatric Oncology Patients And Their Families Through Art Therapy: A Literature Review, Gabby Johnson

Expressive Therapies Capstone Theses

This literature review seeks to answer the question of how art therapy can be used to improve quality of life and connection between pediatric cancer patients and their families.

This literature review also aims to connect art therapy with traditional medical interventions for pediatric cancer patients as a way to create more integrated and supportive care modality that children and their families can benefit from. With a significant amount of children and families being affected by cancer in the world today, it is important to not only focus on the physical health aspects, but the intersection of mental health as …

Undergraduate Baccalaureate Nursing Student Knowledge And Attitudes Towards Neonatal And Pediatric Pain Management Practices, Jordan Lee Slowik

Doctoral Dissertations and Projects

Research has indicated that pain management practices amongst registered nurses is inadequate across all age groups; however, it is frequently noted that children receive less analgesia in comparable situations than adult clients leading to harmful and costly consequences. There is a distinct gap in nursing educational research understanding nursing student knowledge and attitudes towards neonatal and pediatric pain management practices. Using a convenience sample from a private, Christian-based university in the southeastern United States, this study used a quasi-experimental, one-group pretest/posttest design to understand the impact of elective nursing courses on undergraduate baccalaureate nursing student knowledge and attitudes towards neonatal …

Interprofessional Education In Healthcare Related Social Work: A Systematic Review, Devon Vitti

Social Work Doctoral Dissertations

The demand and need for social workers to enter the healthcare field continues to grow in the United States, particularly in integrated care settings working with other healthcare professionals. Social workers bring a unique perspective to the table, particularly when it comes to understanding and addressing intricate health issues like social determinants of health and social inequalities impacting individuals. However, they face numerous obstacles that hinder their ability to function optimally. These challenges begin during their undergraduate and graduate education, where there is a disparity among social work schools regarding the implementation of Interprofessional Education (IPE). This is partly due …

Spiritual Care And The Art Of Holistic Healing At Swedish Hospital In Chicago, Mary Pamela Eke

Doctoral Dissertations and Projects

Despite the importance of spiritual care as an act of holistic healing process, there has continued to be a problem of imbalance between the physical care, and the spiritual and emotional care with cardiac care patients. The purpose of this DMIN action research project is to develop and implement a model of holistic healing for integrating spiritual and emotional care alongside physical treatment. This project’s main goal is to promote a sense of connectivity across the various aspects of physical, social, emotional, and spiritual care for cardiac care patients at Swedish Hospital in Chicago. Utilizing qualitative research methods for data …