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Critical Communication: Improving Care Transitions For Incarcerated Patients Requiring Palliative And End-Of-Life Care, L. Emily Cotter Md, Mph, Gina Lutz Md, Sara Combs Md, Ao Ferguson Mdiv, Ma, Suzanne Stern-Brant Lmsw, Esme Finlay Md, Erin Fitzgerald Do

Quality Improvement/Patient Safety Symposium

Background:

Incarcerated persons are often sicker than the general population, with high levels of medical comorbidities [1]. Among those incarcerated, the elderly population is increasing at much higher rates than younger inmates, and with it rates of age-related chronic illnesses [2-3]. Care transitions, or movement from patients between healthcare settings, increase risk for adverse events due to potential miscommunication during transfers [4-5]. When hospitalized with life-limiting diagnoses, interdisciplinary palliative medicine teams advocate for appropriate patient care for persons who are incarcerated. However, limited resources and communication challenges often lead to inadequate care transitions upon discharge to correctional facilities.

Methods:

A …

The Essential Characteristics Of An Effective Hospice And Palliative Care Nurse, Alexis Doyle

The Eleanor Mann School of Nursing Undergraduate Honors Theses

No abstract provided.

Cervical Cancer-Associated Suffering: Estimating The Palliative Care Needs Of A Highly Vulnerable Population, Eric L. Krakauer, Xiaoxiao Kwete, Khadidjatou Kane, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa, C R Beena Devi C R Beena Devi

Department of Anaesthesia

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.
Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying …

Effects Of Palliative Care On Nurses’ Knowledge And Attitudes, Daniel Kerr

MSN Capstone Projects

Heart failure (HF) is a chronic, progressive disease that affects 6 million Americans (Ng & Wong, 2017). During the course of the disease, patients have worsening symptoms and need increasing levels of care from both medical staff and home caregivers. Often, these caregivers are family members or friends who spend a significant amount of their free time assisting the patient, leading to significant stress and burden on the caregivers. Recent changes in recommendations from the American Heart Association (AHA) include Palliative Care (PC) consultation for patients diagnosed with advanced stage heart failure, but many physicians have not included a PC …

Advocating For Palliative Care In The Intensive Care Unit: A Nursing Approach, Andrea Kirk, Erin Leach

Nursing DNP Projects

Purpose and Rational

Intensive Care Unit (ICU) patients often receive aggressive medical treatment with advanced illness or injury, and frequently have unmet palliative care (PC) needs. ICU nurses bear witness to the suffering of their patients and in turn, suffer a disproportionate amount of moral distress. The purpose of this clinical scholarship project is to empower nurses with knowledge and skills to advocate for PC for critically ill patients within the ICU setting at a Midwestern, urban, academic medical center. This will be achieved by providing education to nurses about PC and its utilization in the ICU setting and implementing …

Factors Influencing The Self-Reported Palliative Care Practices Of Acute Care Nurses, Keshia Kotula, Catherine E. Dingley

Creating Healthy Work Environments (CHWE)

Timely referrals and provision of palliative care (PC) are lacking despite robust evidence for enhanced quality and clinical outcomes. This in-progress study examines factors that influence the nature and frequency of self-reported PC practices of acute care nurses. Findings will generate the requisite knowledge to increase and improve PC delivery.

A Culturally Responsive Community Care Model For Latinos With Cancer, Marianne Congema, Sarah Jane Hoffman, Kim L. Larson, H. F. Mathews, J. P. Moye

Creating Healthy Work Environments (CHWE)

Latinos in the United States have less access to palliative care resources due to numerous sociocultural factors. We explored the meaning of cancer and death among Latino leaders who completed a palliative care training program to serve Latinos with cancer.

Oral Care Experiences Of Palliative Care Patients, Their Relatives And Healthcare Professionals: A Qualitative Study, Delgado M Bernardes, Jos Latour, Helen Neilens, Sarah Griffiths

School of Nursing and Midwifery

Oral symptoms in a growing number of palliative care patients are often neglected. Dental professionals are not always involved in palliative care. Oral care is often inadequately delivered to palliative care patients while oral problems can affect quality of life. A qualitative study was conducted to explore oral care experiences of palliative care patients, their relatives and healthcare professionals (HCPs). Four patients, four relatives and four HCPs were interviewed in a hospice. Transcripts were analysed using thematic analysis and revealed three themes. Patients who were capable of performing oral care mainly brushed their teeth and looked after their dentures. Other …

Beyond Prognosis Communication: Exploring The Existential Dimensions Of Palliative Care Conversations With Adults With Advanced Cancer, Elise C. Tarbi

Sigma Foundation for Nursing Research Grant Reports

Prognosis communication appears to be one key mechanism to achieve the benefits of palliative care (Norton et al., 2013; Thomas et al., 2018). As prognosis communication entails confronting mortality, which can provoke existential concerns (Solomon, Greenberg, & Pyszczynski, 2015), the purpose of this project was to examine the existential dimensions of palliative care conversations involving prognosis communication. This purpose was accomplished through the following aims: (1) Describe how patients, families, and clinicians communicate about existential experience in palliative care conversations; and (2) Explore the intersection between prognosis communication and existential dimensions of conversation.

Reducing Stress And Burnout In Hospice And Palliative Care Through Education, Marvet Wint

Walden Dissertations and Doctoral Studies

AbstractBurnout, a syndrome described as a state of mental and or physical exhaustion, impacts the workforce of hospice and palliative nurses where employees’ behaviors and professional efficacy reflect poorly on their work. The prevalence of burnout among hospice nurses led to the development of this project. The Maslach Burnout Inventory (MBI) served as a reference guide for developing the content, which addressed whether a staff education program at this Southeastern United States facility, would affect a change in knowledge among hospice nurses reduce burnout. Knowles’s theory of adult learning framed this education program on self-care and stress management. Focus was …

Promotion Of Most Forms Through Education About Importance Of Advance Care Planning In Seriously Ill Patients, Nidhi More

DNP Projects

Abstract

Purpose: To establish the importance of early Advance Care Planning (ACP) and improve the utilization of Medical Orders for Scope of Treatment (MOST) forms in seriously ill patients by educating providers and nurses to identify patients who meet specified criteria. The goals of this intervention are reduction of readmissions and better quality of life for this patient population.

Methods: A quasi-experimental design was used for evaluation of an Educational intervention to promote MOST forms, Advance Directives (AD) and Palliative Care (PC) consults. A retrospective and prospective chart review was conducted to determine the number of patients who met criteria …

Creating Joy & Resilience In Times Of Uncertainty, End-Of-Life Nursing Education Consortium, Carol O. Long

General Submissions: Academic Settings and Education-based Materials

Caring for older adults in long-term care facilities during the coronavirus pandemic is extremely challenging. Staff in long-term care are facing fears associated with the pandemic spread, grief associated with patient losses, and families who are distraught because they cannot visit loved ones. This tool helps the leadership at the facility to engage the team and foster community connection with joy and resilience.

Elnec Final Hours: Adapted For Covid-19 Crisis, End-Of-Life Nursing Education Consortium, Betty Farrell

General Submissions: Academic Settings and Education-based Materials

The coronavirus pandemic has made care of patients and their families during the final hours of life uniquely challenging. Families are often not able to be with their loved ones during the end of their lives. Nurses are creating ways to help families virtually say goodbye to their loved ones and have the closure needed to avoid a complicated bereavement period. This document helps the nurse with communication tips, ethical issues, spiritual care needs, selected symptom management related to COVID-19, and care during the final hours.

Establishing Interprofessional Palliative Care Education Across A University System, Jodie C. Gary, Michael Ellis, Zakaria Y. Abd Elmageed, Jeffery Hatala, Joyce Hnatek, Christine L. Kaunas

International Nursing Research Congress (INRC)

This presentation will describe an interprofessional education (IPE) project to develop collaborative learning experiences with palliative care content for multiple health-related programs. The approach engages a team of interdisciplinary educators and content matter consultants to design virtual modular content to align with professional competencies and existing program objectives.

The Condensed Memorial Symptom Assessment Tool And Palliative Care Referrals, Amanda Mertens

International Nursing Research Congress (INRC)

This is an evidence-based pilot study that implemented the Condensed Memorial Symptom Assessment Scale in a small community out-patient oncology department. The purpose was to see if having a screening tool in place increased palliative care referrals.

Elnec Covid-19 Communication Resource Guide: Helping Families Saying Goodbye Virtually To Loved Ones In The Nursing Home And Hospital, End-Of-Life Nursing Education Consortium, Betty Rolling Ferrell

General Submissions: Academic Settings and Education-based Materials

Helping family members say goodbye to loved ones who are dying in the hospital or nursing home is difficult in the best circumstances. With COVID-19, visitation is often not allowed and family have to say goodbye using technology. Nurses at the bedside can help families during this challenging time. This educational material helps the nurse prepare the family for this important conversation.

Newsletter Volume I Issue-Ii January-September-2020, Department Of Oncology

Cancer Updates Research & Education (CURE) Archives

• Faculty Achievements
• Online Conferences and Symposium
• Achievements By Residents & Staff
• Nursing workshops
• Nurse Navigation Program
• Departmental News
• Upcoming Events

A Systematic Review Of Interventions For Family Caregivers Who Care For Patients With Advanced Cancer At Home., Soojung Ahn, Rafael D. Romo, Cathy L. Campbell

Nursing | Faculty Scholarship

OBJECTIVE: To examine the characteristics of interventions to support family caregivers of patients with advanced cancer.

METHODS: Five databases (CINAHL, Medline, PsycINFO, Web of Science, and the Cochrane Library) were searched for English language articles of intervention studies utilizing randomized controlled trials or quasi-experimental designs, reporting caregiver-related outcomes of interventions for family caregivers caring for patients with advanced cancer at home.

RESULTS: A total of 11 studies met the inclusion criteria. Based on these studies, the types of interventions were categorized into psychosocial, educational, or both. The characteristics of interventions varied. Most interventions demonstrated statistically significant results of reducing psychological …

A Comparison Of Interdisciplinary Palliative Care Teams And Leadership Attitudes Of Nci-Designated And Non-Nci-Designated Cancer Centers In The United States From 2009-2018, Joseph Chen

Dissertations and Theses (Open Access)

Background: Interdisciplinary palliative care (PC) teams (IDTs) are essential to improving patient outcomes while cancer center executives have a key role in defining the future of PC. Objectives: To compare PC team compositions and executives’ attitudes towards PC between NCI (National Cancer Institute)-designated cancer centers (NCI-CCs) and non-NCI-designated cancer centers (non-NCI-CCs) in 2018 and to compare changes in team composition and executives’ attitudes and beliefs between 2009-2018. Methods: PC program leaders (PL) and cancer center executives at all 62 NCI-CCs and a random sample of 60 of 1252 non-NCI-CCs were surveyed from April-August 2018. The PL survey examined team composition …

Nurses' Lived Experiences Of Caring In Palliative Care - A Phenomenological Study, Vitor Parola, Adriana Coelho, Olga Fernandes, Joao Luis Alves Apóstolo

General Submissions: Presentations (Oral and Poster)

This study aimed to describe the lived experiences of nurses caring in a palliative care unit.

Goals Of Care Conversations: Palliative Care Practice Change, Jeannine M. Haberman

DNP and Student Works

This project evaluated the effectiveness of AD completion rates after GOC conversations for PC patients in this selected setting. The PICOT question "In an acute care setting, how does the implementation of organizational goals of care (GOC) conversation with palliative care patients affect the number of completed advanced directives upon admission over a 10 week period?" was framed with the Chronic Care Model theory. Methods included a retrospective evaluation of AD documentation and analysis of the relationship of AD completion after the GOC conversations.

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 …

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 …

Urban And Rural Alaskan Physicians’ Knowledge, Attitudes, And Behaviors Regarding Palliative Care, Mary Bernadette Cavalier

Walden Dissertations and Doctoral Studies

Palliative care provides multidisciplinary treatment of the physical, psychological, social, and spiritual needs of patients and families with serious illnesses. Alaska has the highest per capita rates of serious illnesses in the United States, but many Alaskans lack access to palliative care. Using Engel’s biopsychosocial model of care, Saunders’ total pain theory, and Bandura’s theory of self-efficacy, the purpose of this study was to assess the role of physicians regarding palliative care access in Alaska. This quantitative multivariable regression analysis examined the relationship between 133 Alaskan physicians’ knowledge and attitudes (independent variables) and their behaviors (dependent variable) regarding palliative care; …

Nurse Directed Palliative Care Discussions In The Emergency Department, Shannon Lorince Landefeld

Walden Dissertations and Doctoral Studies

Emergency department (ED) nurses are in a unique position to discuss with patients who have life-limiting illnesses. However, due to lack of training, ED nurses are often reluctant to have these conversations. Although ED patients receive written information about advanced directives, there is a gap in practice with discussing palliative and end-of-life care, resulting in increased potential for patient isolation, inconsistencies in treatment modalities, and delayed opportunities for patient-centered goal setting. Therefore, the purpose of this project was to address what resources are available to guide evidence-based practice for ED nurses in a small inner city hospital to implement nurse-directed …

Anticipation, Accompaniment, And A Good Death In Perinatal Care., Bryanna S. Moore, Brian S. Carter, Bryan Beaven, Katie House, Joel House

Manuscripts, Articles, Book Chapters and Other Papers

The ethics of perinatal care, and the experiences of families who receive such care, remains a nascent area of inquiry. It can be hard to see how existing "good death" constructs apply to the experiences of fetal patients and their families. In this paper, we explore two themes raised by a case at our fetal health center: anticipation and accompaniment. In this case, a mother presented to our fetal health center; her unborn son, our fetal patient, was diagnosed with life-threatening hypoplastic left heart syndrome and endocardial fibroelastosis. The parents were told that their son's life expectancy, upon birth, was …

Central Coast Vna Palliative Care Volunteer Program, Jacquelyn Taueetia

Capstone Projects and Master's Theses

The Central Coast VNA Visiting Nurse Association provides the highest quality health care to patients through physicians, hospice medical directors, nurses, medical social workers, spiritual care counselors, and volunteers. VNA currently does not have a volunteer program specifically for palliative care patients for their Palliative Care Team. Palliative care is specialized medical care for people living with a serious illness. The goal is to improve quality of life for both the patient and family by addressing physical, emotional, social, and spiritual needs (VNA, 2019). 94.9% of patients are referred to VNA because they need support for the patient and family …

Conversations Had At Trying Times (Chatt): Development & Testing Of An Advance Care Planning Simulation, Amisha Parekh De Campos

Biennial Convention (CONV)

This presentation will describe a simulation study in advance care planning called Conversations Had at Trying Times (CHATT). This two-phase study consists of simulation development, through standardized guidelines, and simulation testing among registered nurses. The simulation outcomes focus on empowering RNs to have patient-centered conversations in a safe environment.

A Conceptual Model Of Palliative Care Within The Chronic Illness Continuum, Shena Gazaway, Autumn M. Schumacher

Biennial Convention (CONV)

An evidence-based conceptual model was developed concerning the use of palliative care. The model illustrates three phases (early, episodic, late) of palliative care along the chronic illness continuum. Research is needed to determine best nursing practices during the early phase to prevent crises during the episodic phase.

Creating Opportunities For Research Collaboration, Megan E. Pfitzinger Lippe, Polly M. Mazanec, Andra Davis

Biennial Convention (CONV)

This presentation will describe how nurse educators and researchers from across the country collaborated to explore implementation and outcomes of incorporating the End of Life Nursing Education Consortium Undergraduate (ELNEC-UG) online modules into their respective programs.