Digital Commons Network^™

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, …

Physician Behaviors, Nursing, And Other Obstacles In End-Of-Life Care: Additional Critical Care Nurse Perceptions, Elizabeth Elouise Willmore

Theses and Dissertations

Background: Critical Care Nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Barriers to EOL care in ICUs exist and have been previously published, but qualitative reports from CCNs themselves remain scarce. Qualitative data exploring barriers faced during ICU EOL care may increase awareness of obstacles and help remove them. Objective: Excluding family experiences, what are the major themes recounted by CCNs when asked to share common obstacles experienced in providing ICU EOL care? Methods: Members of the American Association of Critical-Care Nurses were randomly surveyed and responses to a single qualitative question were used. …

Meaning-Centered Supervision: A Structured Self-Reflection Model To Reconnect With Personal And Professional Meaning In Palliative Care Work, Rebecca Cammy, Msw, Lcsw

Department of Medical Oncology Posters

Meaning-centered supervision explores participant’s sense of meaning of past, present, and future personal and professional experiences. The series aims to reintegrate selfreflection into clinical practice through experiential exercises, homework journaling, and group discussion. Social workers develop a narrative around themes of professional attitude, living and creating work life, and connections with the social work profession. The goal is to help palliative care social workers create a sense meaning and purpose in their work as they develop their personal and professional identities. Additionally, the hope is to support supervisees through any concerns of burnout and compassion fatigue.

Taking Care Of The Forgotten: A Pastoral Response To The Hospice Care Professional, Constance Friebohle

School of Theology and Seminary Graduate Papers/Theses

No abstract provided.

End-Of-Life Decision Making: Policy And Statutory Progress (2011-2020), Jocelyn Downie, Mona Gupta, L. Wayne Sumner, Joshua Wales

Reports & Public Policy Documents

In 2009, the Royal Society of Canada (RSC) identified a series of urgent scientific and public policy questions. It established a series of five Expert Panels to study the issues and provide recommendations for next steps. It is now timely to revisit the findings of these Expert Panel Reports. What impact have they had? Have their recommendations been implemented? What are the next steps in terms of policy options?

To answer these questions, the RSC is establishing Policy Briefing Committees (PBC) to:

• describe the context, findings, and recommendations of the report;
• track policy developments in relation to the panel’s findings …

Status Of All Senate Bills As Of 8:00 A.M. July 17, 2020 - Final:, Colorado General Assembly

Colorado House and Senate Journals

No abstract provided.

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 …

The Lived Experience Of Work Stress And Coping In Eldercare Hospice Nurses, Yvette Abraham

Walden Dissertations and Doctoral Studies

The number of elderly people living with terminal diagnoses has increased, along with the need for hospice nurses with specialized training to provide high-quality personal care that addresses their unique, critical needs. Research on nurses and other professionals who function in a demanding environment has demonstrated the experience of work stress, and negative physical and psychological consequences. However, little is known about the unique work stress and challenges of hospice nurses who care for the dying elderly. This study explored the meaning of hospice nurses’ experience of work stress and coping. Giorgi’s empirical phenomenological approach guided the development of the …

Evidence-Based Approach To Drug Crisis, Jiebing Wen

Theses and Dissertations--Public Policy and Administration

I am devoted to health policy research, especially tackling the opioid crisis, and evaluating marijuana laws and newly emerging issues associated with legal recreational drugs. Opioid overdose in the United States continues to jeopardize public health. Meanwhile, the majority of states have legalized medical marijuana and one third of them further liberalized recreational marijuana. Marijuana liberalization, although originally independent of the growing opioid crisis, may be a harm reduction approach to the crisis because marijuana may be a substitute for opioids in pain management at a relatively lower risk. However, marijuana liberalization may also lead to marijuana-related harms, such as …