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Elnec Core Module 1: Palliative Nursing Care, Betty Rolling Ferrell, Pamela Malloy, Polly M. Mazanec, Judith Ann Paice, Patrick Coyne

General Submissions: Presentations (Oral and Poster)

Describe the role of the nurse in providing quality palliative care for patients across the lifespan. Identify the need for collaborating with interdisciplinary team members while implementing the nursing role in palliative care. Recognize changes in population demographics, healthcare economics, and service delivery that necessitate improved professional preparation for palliative care. Describe the philosophy and principles of hospice and palliative care that can be integrated across settings to affect quality care at the end of life. Discuss aspects of assembling physiological, psychological, spiritual, and social domains of quality of life for patients and families facing a life‐threatening illness or event.

Elnec Pediatric 2018: Module 1, Betty Rolling Ferrell, Pamela Malloy, Polly M. Mazanec, Judith Ann Paice, Patrick Coyne, Amy Haskamp

General Submissions: Presentations (Oral and Poster)

Principles of Hospice & Palliative Care for Children

Child and family as unit of care with attention to caregiver support

Adolescents and young adults have distinctive needs

Attention to physical, psychological, social, and spiritual needs

Fatigue-Related Symptom Clusters And Their Relationship With Depression, And Functional Status In Older Adults Hospice Patients With Cancer., Suzan Fouad Abduljawad

USF Tampa Graduate Theses and Dissertations

The hospice care population with cancer are often older adults who report many cancer-related symptoms experienced often in clusters. Most prevalent of these symptoms is fatigue and often it co-occurs with depressive symptoms and poor physical functioning. This dissertation examined fatigue, symptom clusters, depression, physical activity, and functional status in older adults with cancer. The aims of the literature review were to understand the relationship among physical functioning, cancer fatigue, fatigue-related symptom clusters, and their relationship with functional status In older adults. The literature related to these associations is insufficient and inconclusive. The methods section aimed to investigate the reliability …

Interdisciplinary Development Of Electronic Palliative Care Decision Support, Ruth A. Bush, Cynthia D. Connelly, Caroline Etland, Tanja Baum, Jane M. Georges

International Nursing Research Congress (INRC)

Following the session the attendee will be able to define palliative care and develop a greater understanding of the challenges and complexities in designing clinical decision support within the EHR for identification of patients who might benefit from palliative care.

Preparing Nurses To Be Palliative Care Leaders Around The World, Polly M. Mazanec, Pamela Malloy

International Nursing Research Congress (INRC)

Millions of people around the world with serious illnesses are in dire need of quality palliative care. Nurses educated in the ELNEC curriculum have become international leaders, improving the way people with serious illness and their families receive care, across the illness trajectory and at end-of-life.

Debate On Physician Assisted Suicide, Sara Pires

Academic Festival

Physician-assisted suicide (PAS) has been a widely debated topic over the last couple of decades. There are many various ways of completing PAS, there is active, passive, voluntary, involuntary, or non-voluntary. There are other end of life approaches, including hospice and palliative care in order to prevent the patient from choosing to end their life pre-maturely. This is a very controversial topic and many people disagree with whether or not people have the right to choose to die, or if physicians even have the right to provide or administer a drug that can induce death. The government and legalization also …

End Of Life Care Medication Health Literacy Pertaining To Aging Adult Populations, Hanna Leschisin

Honors Thesis

In recent years, an expansion of palliative care and hospice care programs has revolutionized how individuals approach death. The philosophies about these programs focus on patient autonomy, dignity, pain management, and improving quality of life, all which could benefit many individuals at the ends of their lives. To increase proper utilization of these programs, there needs to be a focus on increasing health literacy about end of life. Health Literacy is defined by H. Ishikawa and E. Yano as pertaining to the importance of using health information as a resource to allow greater patient participation in managing and making competent …

[Excerpt From] Hospice & Palliative Care Handbook (3rd Ed.), Tina M. Marrelli

Sigma Publications: Book Excerpts

This item record pertains to an excerpt from Hospice & Palliative Care Handbook(3rd ed.), provided free of charge by the publisher.

About this book: Hospice & Palliative Care Handbook (3rd ed.), offers concise, focused coverage of all aspects of hospice and palliative care for clinicians, managers, and other team members who provide important care while meeting difficult multilevel regulations. Author Tina M. Marrelli, Director of the first U.S. hospice program to attain Joint Commission accreditation for hospice services, helps caregivers meet quality, coverage, and reimbursement requirements in daily practice and documentation. Filled with key topics such as professional standards …

Incorporation Of An Interprofessional Palliative Care-Ethics Experience Into A Required Critical Care Acting Internship., G. R. Goldberg, J. Weiner, A. Fornari, R. E. B. Pearlman, G. A. Farina

Journal Articles

Introduction: The literature documents inadequate palliative medicine training in undergraduate and graduate medical education. As the population lives longer, many people will experience multiple chronic illnesses and the associated symptom burden. All physicians involved in clinical care of patients need to be equipped with the knowledge, attitudes, and skills necessary to provide palliative care, yet most physicians do not feel adequately prepared. We designed a curriculum to provide a meaningful palliative care-ethics (PCE) clinical experience to prepare senior medical students for future practice regardless of specialty choice.

Methods: The Zucker School of Medicine at Hofstra/Northwell integrated a PCE experience into …

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 …

Social Support, Psychological Distress, And Behavioral Outcomes Among Palliative Care Caregivers, Monique Lashone Aguirre

Walden Dissertations and Doctoral Studies

Social support and acute care facility providers need information about how to help improve the practices and knowledge of caregivers related to the stages of palliative care. The purpose of this study was to examine whether there was a significant association between social support and psychological distress and behavioral outcomes among palliative care caregivers, and to determine to what extent social support buffered psychological distress and behavioral outcomes. The quality-of-life model guided the study. The study used a quantitative cross-sectional research design with secondary data analyses. The sample included 320 adult family caregivers who were part of a telephone survey …

The Impact Of A Structured Palliative Care Program, Nadia A. Prince-Williams

Biennial Convention (CONV)

In September 2016, hospital readmission rates were on the rise at 16.8%, with COPD and CHF rates above benchmark at 15% and 19.5%. A structured palliative care program was developed to decrease fragmentation in healthcare practices. After implementation, COPD readmission rates decreased to 8.3% and CHF to 13.2%.

Impact Of Interdisciplinary Rounds On Palliative Care Measures And Patient Outcomes In Non-Intensive Care Settings, Catherine V. Smith, Kathie S. Zimbro

Biennial Convention (CONV)

Interdisciplinary rounds (IDRs) have been described as a method to enhance teamwork, collaboration, and contribute to high-quality, patient-centered decisions. In this study, Clinical Nurse Specialist-led IDRs had a positive impact on select quality and utilization outcomes for adult patients on a hospitalist service.

Literature Review Of Newly Graduated Nurses' Perceptions Of Preparation To Provide Palliative Care In Hospitals, Latrina T. Geyer

Biennial Convention (CONV)

A comprehensive review of literature was conducted to explore newly graduated nurses' perceptions of education preparation to use palliative care principles in acute care settings. This poster will summarize the comprehensive review of literature and include gaps identified in the literature which should be addressed in future studies.

Effect-Of-Life Review With Patients On Palliative Care Nurses' Practice And Views About Life And Death, Miyuki Kinoshita, Noriko Watanabe, Nahoko Saita, Hitomi Takemoto

Biennial Convention (CONV)

Life review with patients and their family members influenced nurses' practice and view about life-and-death. Proving life review therapy affected nurses' views on life-and-death and nurses had deeper understanding and developed more trusting relationships with patients and family members.

Transforming Palliative Care: The Compassionate Collaborative Care Model, Adelais Markaki, Kathryn A. Pfaff

Biennial Convention (CONV)

The compassionate collaborative care (CCC) model presents new opportunities for nurses to transform palliative care globally by strengthening patient-centered care, empowering individuals and teams in decision making, fostering interprofessional communication and cultivating a collaborative practice organizational culture.

Processes And Meanings Of The Patient-Family Caregiver Dyad In Palliative Care During The Hospital-Home Transition, Mauricio Sr. Arias, Gloria Mabel Carrillo Gonzalez, Sonia Carreno-Moreno, Rocio Lopez, Diana Cardenas

Biennial Convention (CONV)

This work aimed to describe the experience of the patient-family caretaker dyad in palliative care during the transition process between the hospital and the home at Colombia's National Cancer Institute in Bogota.

Perceived Knowledge And Perceptions Of Palliative Care Among Advanced Practice Cardiac Providers, Jordan Vance

Doctoral Dissertations and Projects

Providers of healthcare have continued to focus on addressing patients’ chronic health outcomes. When understanding how to manage chronic disease, there remains many opportunities in facilitation of better management. With such a wide range of individuals who suffer with a chronic condition, better management to address this population is essential. Palliative care aids in accomplishing this task. It was seen that there was a lack of education in relation to palliative care, with perceptions that continued to be a barrier to the utilization of the service. Due to the lack in education, the strongest barrier to palliative care service utilization …

Importance Of Palliative Care In End-Stage Liver Disease: A Rising Global Issue, Renee Pozza, Bonita Huiskes, Anna Marie Hefner

International Nursing Research Congress (INRC)

The disease and management of end stage liver disease is a complex issue requiring a multi-disciplinary team approach. Often these individuals seek care from a variety of providers with resulting fragmentation and variable outcomes. This presentation aims to identify applicability from heart failure guidelines for palliative care to ESLD.

Growing The Next Generation Of Nurse Leaders In Palliative Care: An International Case Study, Kathryn A. Pfaff, Linda J. Patrick, Laurie Freeman-Gibb

International Nursing Research Congress (INRC)

This session will report a case study evaluation of an innovative palliative care scholarship program that funds graduate nursing students from Canada and the UK to learn and translate evidence-based practices in palliative care. Positive outcomes for the participating scholars, universities, communities, and hospices are highlighted.

Gaps In Palliative Care Provision In Saskatchewan, Canada: Learning From Palliative Care Management, Susan Eva Fowler-Kerry, Louise Racine

International Nursing Research Congress (INRC)

Purpose: This study is part of an ongoing project to develop a working knowledge about the long-standing uneven development and delivery of palliative care in Saskatchewan, Canada; subsequently providing a foundation for continuing study and facilitating practical improvement of palliative care programs.

Methods: The results to be presented are based on the current stage of this project, the analysis of longitudinal survey data which were collected from the management personnel of palliative care in each health region in 1998, 1999 and 2002. The three surveys are composed of both close-ended and open-ended questions, therefore both quantitative and qualitative analysis are …

Utilizing Clinical Decision Support Within The Electronic Health Record To Screen For Palliative Care, Tanja Baum, Ruth A. Bush, Caroline Etland, Cynthia D. Connelly

International Nursing Research Congress (INRC)

Purpose: Timelier referral to palliative care services (PCS) within the acute care setting is a health care priority. End-of-life consumes a disproportionate share of healthcare dollars with studies indicating PCS can save hospitals approximately $1.3 million annually, for every 500 consults completed. Strategies to increase timelier referral are needed. Integration of electronic clinical decision support and utilization of triggers to identify individuals who may benefit from palliative care, using an algorithm embedded with the electronic health record (EHR) may facilitate this identification, but lacks empirical support.

The purpose of this research was to utilize variables available in the electronic healthcare …

Screening For Palliative Care Patients By Utilizing Clinical Decision Support Within The Electronic Health Record, Tanja Baum, Ruth A. Bush, Caroline Etland, Cynthia D. Connelly

International Nursing Research Congress (INRC)

Purpose: Approximately $1.3 million annually can be saved when 500 palliative care consults are completed within the acute care setting. With 90 million Americans, of whom 20% are Medicare recipients that suffer from chronic medical conditions, 500 consults are not a distant number. The electronic clinical decision support and utilization of triggers to identify individuals who might benefit from palliative care using an algorithm within the electronic health record (EHR) can enable the multidisciplinary team to facilitate palliative care services.

The purpose of this feasibility study was to utilize variables available in the EHR of palliative care patients receiving palliative …

Clinicians’ Perspectives On Adopting A Lung Cancer Palliative Care Intervention, Shaunna Siler

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the significant progress in implementing palliative care interventions for cancer patients, few intervention studies seek healthcare clinicians’ input prior to implementation. The purpose of this research was then to explore palliative care and oncology clinicians’ (e.g., physicians, nurses, social workers, and chaplains) perspectives on current challenges and useful practices in meeting the quality of life needs of lung cancer patients and family caregivers, and to increase the likelihood of the adoption of a palliative care intervention based on understanding current trends in palliative care delivery at three outpatient oncology sites. The conceptual framework used for this study was the …

Physician Orders For Life-Sustaining Treatment (Polst) Utilization In A Skilled Nursing Facility: An Educational Quality Initiative, Ryan Hazley Bsn, Rn, Dnp Student, Karl Steinberg Md, Cmd, Joseph Burkard Dnsc, Crna

Doctor of Nursing Practice Final Manuscripts

According to expert reports and recent research, frequent clinician-patient conversations about individual end-of-life preferences are necessary to avoid unwanted treatment and to ensure that desired treatments are received. The ongoing diffusion of Physician Orders for Life-Sustaining Treatment (POLST) educational initiatives in skilled nursing facilities (SNFs) are vital to success of California’s POLST program, which is now recognized as only 1 of 3 mature POLST programs in the country. The purpose of this evidence-based practice project was to answer the question: Among staff in a skilled nursing facility, does implementing a formal POLST education program compared to current practice improve staff …

Acceptability Of The Md Anderson Symptom Inventory And Qualitative Analysis Of Barriers To Palliative Care Services For Rural And Non-Rural Populations, Daniel M. W. Johnson

Doctoral Projects

The United States health system strives to improve the care patients receive while reducing healthcare expenditures. A significant portion of the nation’s healthcare expenditure is spent on end of life care. Palliative care provides one solution to reducing healthcare expenditures while improving the patient experience. Reducing symptom intensity is one example of palliative care’s success. A midwest palliative care program was tasked to gather quality data on the service’s ability to manage patient symptoms.

The program selected the MD Anderson Symptom Inventory to improve symptom assessment and provide quality metrics for the organization. Additionally, research suggests rural populations have poorer …

Toolkit Development For A Community-Based Palliative Care Program, Tanya A. Rowerdink

Doctoral Projects

The quality of care in the U.S. at the end of life is poor, yet comes with a high price. Since the Institute of Medicine’s (IOM) report Approaching Death in 1997, inpatient palliative care programs in hospitals with 50 beds or more have grown by 165%. In 2015, the IOM had a follow up report, Dying in America that indicates the need for community-based palliative care programs to increase access of care for individuals who are homebound or live in rural communities. In January 2016, the Centers for Medicare and Medicaid Services (CMS) initiated the Medicare Care Choices Model (MCCM) …

Nurses' Attitudes Toward Death: Examining The Relationship With Background And Palliative Education And Training Variables, Julie Dawn Vognsen

USF Tampa Graduate Theses and Dissertations

The purpose of this study was to describe Registered Nurses’ attitudes toward death and their perspectives on education and training related to death and end-of-life patient care. A complementary goal was to determine whether nurses’ attitudes and perspectives are associated with background variables. The three attitudes toward death included anxiety, escape, and neutral attitudes. The background variables of the nurses included formal educational level, age, gender, ethnicity, years of nursing practice, state of residence, and area of nursing practice.

A survey including four sections was used for data collection. The first section of the survey utilized an established 32-item survey …

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 …

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 …