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Current Status And Future Perspective Of Hospital Medicine In Medical Education, Nin-Chieh Hsu, Chia-Lin Tseng, Yu-Feng Lin, Tzung-Dau Wang, Wang-Huei Sheng

Journal of Medical Education

Hospital medicine emerged in the United States in the 1990s to cope with the growing need for integrated care for complex and ageing hospitalized patients. The hospitalist model has rapidly spread out worldwide to European and Asian countries. It was also introduced to Taiwan in 2009 and obtained the government support since 2015 with a pilot project among more than two thirds of medical centers. Hospital medicine has also involved in medical education in the US, with medical schools and residency programs offer dedicated training in hospital medicine. Hospital medicine aims to provide a highly coordinated, patient-and-family-centered, goal-directed care to …

My Body, My Choice: Should Physician-Assisted Suicide Be Legalized In The United States For Individuals With Chronic Mental Illness?, Angelika Anderson

Texas A&M Law Review

Many individuals with mental illness wish to die because the symptoms of their illness are unbearable. They shoot, suffocate, and poison themselves to make their pain go away. Because this is a statistical reality, a more certain and less violent means of death should be legalized. This Comment advocates for the legalization of physician-assisted suicide (“PAS”). As of 2022, nine states and the District of Columbia have legalized PAS for terminal illness, but this Comment argues that all fifty states should legalize PAS and not only for terminal illness, but for chronic mental illness as well. To do so, this …

Incarceration-Related Stigma And Caring Self-Efficacy Among Long-Term Care Nurses, Sandra D. Langston

Dissertations, Theses, and Capstone Projects

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population.

Aims/Purpose: This study examined the effects …

Raps Sheet, February 2023, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.

Improving Comfort And Confidence With Advance Care Planning In Primary Care, Thomas Krajewski, Donald Courtney, Tyler Kilgore

South Atlantic Division GME Research Day 2023

No abstract provided.

“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 …

Analysis Of Palliative Care Knowledge And Symptom Burden Among Female Veterans With Serious Illness: A Cross-Sectional Study, Brandon M. Varilek, Patricia C. Da Rosa

College of Nursing Faculty Publications

Background: The female Veteran population is rapidly growing, as is their use of Veterans Affairs (VA) medical centers (VAMCs). Additionally, 90% of female Veterans are under 65 years old, meaning healthcare providers at VAMCs must be ready to manage the complex serious illnesses that affect female Veterans as they age. These serious illnesses require proper medical management, which can include palliative care. However, little palliative care research includes female Veterans.
Aims: The aims of this cross-sectional study were to examine palliative care knowledge and symptom burden among female Veterans’ and examine factors associated a symptom burden scale.
Methods: Consenting participants …

Home Healthcare Nurse Knowledge Of Palliative Care And Hospice: A Quality Improvement Project, Alyse Jewel Mcgarraugh

Regis University Student Publications (comprehensive collection)

This DNP project's objective was to educate home healthcare (HHC) nurses about palliative care/hospice (PC/H) benefits so they can recommend a referral if they believe it would enhance the patient's and family's quality of life. The purpose of the study was to determine if providing additional education to HHC nurses improves their perceptions of palliative care and hospice knowledge. The HHC nurses at one organization were provided with an information sheet, a consent form, demographic inquiries, and a pre-survey and instructed to review an evidence-based educational module. Upon completion of the module, participants were requested to complete a post-survey. After …

Medication Cost Reduction And Substitution Strategies Through The Mymetrx Program At Catholic Hospice, Ana M. Sanchez Monroig, Tracy Romanello, Joseph Solien, Sanaz Kashan, Angel E. Sanchez Artiles

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Introduction: As healthcare costs continue to rise, and with the growing awareness of the potential harms of polypharmacy, there is an ongoing need to explore strategies to optimize medication use in hospice settings. Strategies include deprescribing and medication substitutions, which ensure the safety and comfort of patients but can also lead to significant medication cost reduction.

Objectives: The primary objective of this study was to evaluate the impact of the MyMetRx program on medication cost reduction and medication substitutions within the context of Catholic Hospice. The program aimed to optimize medication …

Katie Beckett Program Update: A Joint Report To The Tennessee General Assembly [2023], Tenncare (Program), Tennessee. Department Of Intellectual And Developmental Disabilities

Katie Beckett Report to the General Assembly

This document contains the status of the Katie Beckett program, created in 2019 to assist Tennessee children with disabilities who are not eligible for Medicaid.

Multigenerational Legacy Projects, Kailey A. Bradley

Adultspan Journal

Multigenerational legacy projects and activities facilitate meaning making and instill hope for further generations. Hospice and palliative care entities can use legacy projects to help terminally ill clients share how they want to be remembered. Legacy projects come in many forms including but not limited to scrapbooks, holiday rituals, and storytelling. In this perspective piece, examples of legacy projects will be explored as ways to process loss.

Keywords: Legacy projects, bonds, hospice/palliative care, meaning construction, bereavement.

The Effect Of Early Palliative Care Consultation For Patient With Traumatic Brain Injury On Procedure Utilization, Length Of Stay And Discharge Location, Abdulelah Almutairi, Donald Courtney, Heather Rhodes

South Atlantic Division GME Research Day 2023

No abstract provided.

From Prison Zooms To Hospital Rooms: Unmasking The Positives Of Remote Education, Molly Chao Yeselson

Scripps Senior Theses

From Prison Zooms to Hospital Rooms: Unmasking the Positives of Remote Education is the culmination of a seven-year battle for my life and my education. Remote and hybrid education are perpetually identified as the cause of pandemic-era learning deficits. My project seeks to challenge such rhetoric by detailing the positive educational experience I, a student with a disability, along with my incarcerated peers, have had thanks to distance learning. I argue that as the world shifts from a pandemic to an endemic approach to COVID-19, higher education must keep its virtual doors open to nontraditional students.

Facilitating Palliative Care In A Critical Access Hospital System: Implementation Of Screening And Educational Interventions, Michele Lovell

DNP Scholarly Projects

BACKGROUND: The United States health care system faces the dual challenge of an aging population with a concomitant increase in the presence of chronic and serious illness, the care of which accounts for the nation’s largest expenditure of burgeoning healthcare costs. Palliative care is specialized care for people with serious illness aimed at reducing suffering, optimizing quality of life, and enhancing medical decision making. An ample evidence base demonstrates that palliative care increases both quality of care and patient and family satisfaction while also reducing associated costs. The aim of this quality improvement project was to facilitate palliative care services …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

บทบาทพยาบาลกับการตัดสินใจเชิงจริยธรรมในผู้ป่วยมะเร็งระยะท้าย: ประเด็นการยับยั้ง/การถอดถอนการรักษาพยุงชีพ, บุญสิตา ทิงาเครือ, พิรนันท์ ศิริ, นิชาภา พุมสอน, อิสระพันธ์ เรืองทอง, จันจิรา เพ็ญ, วาสินี วิเศษฤทธิ์

Journal of Nursing Research, Innovation, and Health

การตัดสินใจเชิงจริยธรรมเป็นกระบวนการที่ช่วยให้พยาบาลได้ตรวจสอบประเด็นขัดแย้งทางจริยธรรมในการปฏิบัติการพยาบาลอย่างเป็นระบบและเป็นองค์รวม โดยยึดหลักเหตุผลเชิงจริยธรรม พยาบาลผู้ตัดสินใจ  จะต้องรู้องค์ประกอบและปัจจัยที่เกี่ยวข้องกับการตัดสินใจและสามารถเลือกกระทำหรือไม่กระทำในสถานการณ์ที่เกิดขึ้นนั้นได้ เนื่องจากพยาบาลถือว่าเป็นบุคลากรทางด้านสุขภาพที่มีความใกล้ชิดกับผู้ป่วยมากที่สุด ในหลายสถานการณ์ที่พยาบาลต้องเผชิญกับประเด็นทางจริยธรรม โดยเฉพาะอย่างยิ่งในบทความนี้แสดงประเด็นที่เกี่ยวข้องกับการการยื้อหรือยุติการมีชีวิตอยู่ในผู้ป่วยมะเร็งระยะท้าย ถือได้ว่าเป็นมิติใหม่ที่ท้าทายบทบาทของพยาบาล พยาบาลจึงมีบทบาทสำคัญที่จำเป็นต้องมีทักษะ ความรู้ และประสบการณ์หลายด้านในการดูแลผู้ป่วยมะเร็งระยะท้าย รวมทั้งทีมบุคลากรด้านสุขภาพต้องให้ความสำคัญกับกระบวนการตัดสินใจเชิงจริยธรรมในการดูแลประคับประคองด้านข้อมูลและด้านจิตใจของผู้ป่วยและครอบครัว เพื่อเพิ่มความมั่นใจและศักยภาพในการดูแลผู้ป่วยมะเร็งระยะท้ายแบบองค์รวม ส่งผลให้ผู้ป่วยได้รับการดูแลอย่างสมศักดิ์ศรีความเป็นมนุษย์และเกิดประโยชน์สูงสุดต่อผู้ป่วยและครอบครัว

Giving Effective And Timely Hospice Education To Lessen Participant Stress (Get Helps), Caroline Rose Carter

Master's Theses and Capstones

In 2022, 1.72 million people chose to use hospice as their end-of life care. This is a 6.8% increase from 2019, and the number of patients who choose to use hospice is increasing (Summers, 2022). The aim of this quality improvement (QI) study was to decrease levels of stress reported by the patient and informal caretakers by combining the information from the hospice program’s admission packet and other approved handouts, while standardizing the verbiage through a Flesch-Kincaid readability scale to an eighth-grade reading level. Pre-survey perceived stress scores averaged 22.97 on a modified Perceived-Stress Scale, and the mean of the …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Disrupting And Expanding The Discourse: Palliative Care Clinicians' Experiences With Patients' Non-Physical Suffering, Maxxine Rattner

Theses and Dissertations (Comprehensive)

While one of the primary aims of palliative care is to prevent and relieve suffering, both physical and non-physical, research to date has been very limited re: clinicians’ experiences with patients’ non-physical suffering (e.g., suffering that may be psychological, emotional, social, spiritual and/or existential in nature); both how clinicians work with/respond to this kind of suffering in their day-to-day work, and the effect of this aspect of their work on clinicians themselves. No research to date has considered the impact of palliative care’s dominant non-physical suffering discourse — which presents the relief of non-physical suffering as falling along a binary …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Advance Care Planning In Cancer Patient - Caregiver Dyads, Natasha Michael

Theses

For many, a cancer diagnosis signals death's inevitability and elicits much existential concern. In the quest for life prolongation, many are offered or seek life-sustaining treatments, fail to appreciate a declining trajectory and lack the opportunity to seek information or plan meaningfully for their future.

Advance care planning (ACP) provides an avenue for patients and their caregivers to plan for future care. ACP is defined ‘as a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care’ and is a key quality indicator in …

The Effectiveness Of Community-Based Palliative Care Program Components: A Systematic Review, M. Courtney Hughes, Erin Vernon, Allison Hainstock

Faculty Articles, Papers, and Other Scholarship

Background: there is evidence that community-based palliative care programs can improve patient outcomes and caregiver experiences cost-effectively. However, little is known about which specific components within these programs contribute to improving the outcomes.

Aim: to systematically review research that evaluates the effectiveness of community-based palliative care components.

Design: a systematic mixed studies review synthesizing quantitative, qualitative and mixed-methods study findings using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PROSPERO: ID # CRD42022302305.

Data sources: four databases were searched in August 2021 (CINAHL, Web of Science, ProQuest Federated, and PubMed including MEDLINE), and a close …

Factors Impacting Serious Illness Care In Alabama: An Assessment Of The Current State Of Hospital Palliative Care, Amy M. Beasley

All ETDs from UAB

BACKGROUND: Palliative care (PC) use has been shown to offer many benefits to patients and families. Hospital PC has expanded in the United States, though growth has been limited within hospital types and geographic locations. According to the Center to Advance Palliative Care (CAPC), Alabama was rated a “D,” indicating that significant improvements in PC are needed. The purpose of this study was to develop a thorough description of access to palliative care in Alabama hospitals. METHODS: A mixed methods multiple case study was employed with quantitative data embedded into a qualitative case study approach. Four hospitals were selected based …

Combating Compassion Fatigue In The Emergency Department, Pam Packard

Doctor of Nursing Practice Projects

Combating compassion fatigue in the emergency department is vital to nurses’ well-being. Compassion fatigue is the result of negative physical, emotional, and spiritual strains that often burden nurses. The weight of compassion fatigue is explored throughout this conceptualization of Combating Compassion Fatigue. Two questions were explored: Does compassion fatigue affect compassion satisfaction? If so, is compassion fatigue a precursor to suboptimal compassion satisfaction?

แนวทางการออกแบบสภาพแวดล้อมที่เหมาะสมกับผู้สูงอายุในสถานดูแลผู้ป่วยระยะสุดท้าย (Hospice) สำหรับประเทศไทย, ไพทินี จินตกานนท์

Chulalongkorn University Theses and Dissertations (Chula ETD)

สถานดูแลผู้ป่วยระยะสุดท้ายเป็นสถานพยาบาลหรือสถานบริบาลที่รับผู้ป่วยในเฉพาะผู้ป่วยระยะสุดท้าย โดยเน้นการรักษาแบบประคับประคองที่มุ่งเน้นเรื่องการรักษาแบบองค์รวม การลดและบรรเทาความเจ็บปวด เพื่อนำไปสู่การตายดีของผู้ป่วย ซึ่งในปัจจุบันสถานดูแลผู้ป่วยระยะสุดท้ายจำเป็นอย่างยิ่งในประเทศไทยสืบเนื่องมาจากปัญหาอัตราการครองเตียงในสถานพยาบาลสูงมาก ทำให้ไม่สามารถรองรับกลุ่มผู้ป่วยระยะสุดท้ายที่เป็นกลุ่มมีการครองเตียงนานได้เพียงพอ เพื่อศึกษาและนำเสนอแนวทางการออกแบบสภาพแวดล้อมทางกายภาพที่เหมาะสมสำหรับสถานดูแลผู้ป่วยระยะสุดท้ายในประเทศไทยโดยเฉพาะสำหรับกลุ่มผู้สูงอายุที่มีผู้ใช้บริการส่วนใหญ่ในสถานดูแลผู้ป่วยระยะสุดท้าย การวิจัยครั้งนี้มีวัตถุประสงค์เพื่อศึกษาสภาพแวดล้อมและพฤติกรรมผู้ใช้งานของสถานดูแลผู้ป่วยระยะสุดท้ายในประเทศไทยเพื่อนำเสนอแนวทางการออกแบบสภาพแวดล้อมที่เหมาะสมโดยมีการลงพื้นที่สำรวจเก็บข้อมูลทางกายภาพของพื้นที่โครงการกรณีศึกษาศูนย์ธรรมศาสตร์ ธรรมรักษ์ โรงพยาบาลธรรมศาสตร์เฉลิมพระเกียรติ มหาวิทยาลัยธรรมศาสตร์ และ การุณรักษ์ ฮอสพีซ โรงพยาบาลศรีนครินทร์ มหาวิทยาลัยขอนแก่น และสัมภาษณ์ผู้ใช้งานในโครงการ และผู้เชี่ยวชาญในสาขาที่เกี่ยวข้องจากการศึกษาพบว่าการออกแบบสภาพแวดล้อมที่เหมาะสมสำหรับผู้สูงอายุในสถานดูแลผู้ป่วยระยะสุดท้าย ตัวโครงการควรตั้งอยู่ในสถานที่ที่มีความสงบและใกล้ชิดธรรมชาติ สามารถเข้าถึงตัวโครงการได้สะดวก ตัวอาคารไม่ควรเป็นอาคารสูง สามารถแบ่งสัดส่วนของพื้นที่ได้เป็น 5 ส่วน คือ 1)ส่วนบริหารโครงการ 2)ส่วนบริการทางการแพทย์ 3)ส่วนพื้นที่อเนกประสงค์ 4)ส่วนพักอาศัยผู้ป่วย และ 5)ส่วนสนับสนุนโครงการ ในการออกแบบสภาพแวดล้อมความสบายใจในการใช้งานเป็นสิ่งสำคัญ ดังนั้นสภาพแวดล้อมที่สามารถสร้างความคุ้นเคยผสมผสานกับสภาพแวดล้อมเยียวยาที่เอื้อต่อการบำบัดและฟื้นฟูประสาทสัมผัสในทุกๆด้าน รวมถึงหลักการออกแบบเพื่อคนทั้งมวล มีผลต่อการออกแบบสภาพพื้นที่ภายในโครงการ สถานที่ที่ผู้ใช้งานมีการใช้งานเป็นประจำมีผลต่อขนาดของพื้นที่ ดังนั้นพื้นที่ส่วนพักอาศัยของผู้ป่วยจึงมีพื้นที่มากที่สุดในโครงการ โดยทั้งนี้ตัวโครงการยังต้องสามารถตอบสนองความต้องการด้านการแพทย์ และความปลอดภัยในการใช้งานตามมาตรฐานได้อย่างครบถ้วนงานวิจัยนี้แสดงให้เห็นแนวทางในการออกแบบสภาพแวดล้อมที่เหมาะสมกับในสถานดูแลผู้ป่วยระยะสุดท้ายสำหรับประเทศไทยโดยเฉพาะกับกลุ่มผู้สูงอายุ ซึ่งในอนาคตควรมีการวิจัยกับผู้ป่วยทุกช่วงวัย เพื่อให้แนวทางดังกล่าวสามารถนำไปใช้กับสถานดูแลผู้ป่วยระยะสุดท้ายได้อย่างครอบคลุม เพื่อส่งเสริมและพัฒนาคุณภาพชีวิตของผู้ป่วยและยกระดับคุณภาพการตายดีในประเทศไทย

Survey Of Attitudes Toward Performing And Reflecting On Required Team Service-Learning (Sasl): Psychometric Data And Reliability/Validity For Healthcare Professions Students In Preclinical Courses, Lon J. Van Winkle, Shane L. Rogers, Bradley O. Thornock, Brian D. Schwartz, Alexis Horst, Jensen A. Fisher, Nicole Michels

Research outputs 2022 to 2026

Purpose: Previously we assessed healthcare professional students’ feelings about team-based learning, implicit bias, and service to the community using an in-house paper survey. In this study, we determined whether this survey is a reliable and valid measure of prospective medical students’ attitudes toward required service-learning in an Immunology course. To our knowledge, no published questionnaire has been shown to be dependable and useful for measuring such attitudes using only eight survey items. Methods: Fifty-eight prospective medical students in Colorado (CO) and 15 in Utah (UT) completed the same Immunology course using remote technology. In addition to the usual course content, …

Hearing Aid Loan Program For Hearing Loss At The End Of Life, M. Courtney Hughes, Diane Schecklong, King Chung

Faculty Articles, Papers, and Other Scholarship

This article describes a hearing aid loan program to provide free amplification devices for patients at the end of life to help them communicate more effectively at this critical time. It includes steps for establishing such a program, addressing challenges, and the role of the informal caregiver throughout the intervention. Healthcare professionals and social workers are encouraged to develop similar programs and use the information here as helpful suggestions to consider for their programs.

The Effect Of Standardized Patient Education On 30-Day Hospital Readmissions For Heart Failure Patients In The Outpatient Setting, Lurie Dimalanta

Master's Projects and Capstones

Problem: Heart failure (HF) is the second leading condition of hospital readmissions. Evidence shows that patient education on self-care and disease management can help reduce and prevent 30-day hospital readmissions. Registered nurse case managers (RN CMs) can help improve patients' ability to self-manage their condition and prevent 30-day hospital readmissions by applying a standard approach to patient education.

Context: The Integrated Care Management (ICM) is an outpatient department that provides post-discharge patient calls. The ICM RN CMs utilized various HF patient education tools for patient teaching. The organization’s HF task force developed health-literate patient resources to be used …

An Integrative Review: The Experiences Of Stress, Burnout, And Compassion Fatigue By Ambulatory Care Nurses, Rajean Adams

Master of Science in Nursing Final Projects

Abstract

Aim: One aim of this integrative review is to highlight workplace issues outpatient (ambulatory care) nurses experience, related to stress, burnout, and compassion fatigue. Another aim is to bring awareness to and discuss recently implemented tools and strategies to help alleviate these manifestations.

Background: Stressors in the outpatient setting date back to the 1970s when psychologist Herbert Freudenberger mentioned the burnout he experienced while in a Free Clinic. In modern-day, half of nurses experiencing workplace burnout, confess to feeling emotional exhaustion. Various studies discuss the challenges nurses endure in the inpatient setting, but only a few focus on ambulatory …

Raps Sheet, December 2022, Retirement Association Of Portland State

RAPS Sheet: Monthly Newsletter

No abstract provided.