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 …

[Excerpt From] Anatomy Of Writing For Publication For Nurses (5th Ed.), Cynthia Saver

Sigma Publications: Book Excerpts

This item record pertains to an excerpt from Anatomy of Writing for Publication for Nurses, 5th Edition, which is provided free of charge by the publisher.

About this book:

If you need to make the leap from single sentences to a published manuscript, you will find valuable help and resources in this fully updated fifth edition of Anatomy of Writing for Publication for Nurses.

In this practical and useful guide, lead author and editor Cynthia Saver removes the fear and confusion surrounding the writing and publishing process. Along the way, 25 of nursing's top writing experts and decision-makers …

Development Of A Nursing Clinical Evaluation Instrument Using The Cipp Model, Carolyn W. Milburn

Doctor of Education (EdD)

National nursing education organizations are responding to the trends and challenges in healthcare with updated professional guidelines and a call for transformation in nursing education. The purpose of this study was to improve clinical performance evaluation in a baccalaureate prelicensure nursing program by developing a clinical evaluation instrument that is aligned with The Essentials: Core Competencies for Professional Nursing Education. The Context Input Process Product (CIPP) Evaluation Model was used as a framework to guide decisions and appraise the quality of the end product. During instrument development, I revised an existing instrument to align with the Essentials, assessed the face …

Eye Care For Corneal Transplant Donors In The Icu: What We Didn’T See Coming, Ashton Lackey, Joey Royea, Alexandra Hartman, Aaron Worthley, Abbi Mason, Bryan Howington, Bharat Meenavalli, George Helmrich, Stephen M. Meyer

South Atlantic Division GME Research Day 2024

No abstract provided.

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Katie Beckett Program Update: A Joint Report To The Tennessee General Assembly [2024], 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.

Establishing A Protocol For Hospice Compassionate Withdrawal Of Ventilatory Support In The Home Setting, Georganna Rosel, Ana Sanchez, Reuben Smith

South Atlantic Division GME Research Day 2024

No abstract provided.

Understanding Hospital-Based Nurse End-Of-Life Care, Knowledge, And Comfort: A Quality Improvement Project, Emma Doran

Honors Theses and Capstones

Providing physical, emotional, and spiritual care to patients at the end of life (EOL) can relieve their suffering and the pain experienced by loved ones in their presence. As death approaches, patients’ symptoms may require increased comfort measures, and it is imperative that all nurses be properly trained and prepared to provide this care. In this quality improvement (QI) project, the End-of-Life Professional Caregiver Survey (EPCS) and demographic and experiential questions were administered in the form of a Qualtrics survey to nurses working on an acute care inpatient unit at a healthcare organization in New England. 18 survey responses were …

Minding The Maid Gap: Issues In Expansion Of Medical Aid In Dying To Sole Underlying Conditions Of Mental Illness In U.S. States, Alexandra Rubino

Student Works

No abstract provided.

Relationships Of Secondary Traumatic Stress, Compassion Fatigue, And Compassion Satisfaction Among Maternity Nurses Caring For Patients Who Succumbed To Maternal Mortality, Debra Joy Mendelson

Theses & Dissertations

Background:

Maternity nurses work where positive outcomes are the norm, leaving them more vulnerable to the adverse effects of dealing with death. Limited data indicate that caring for a maternity patient who dies may result in nurses developing secondary traumatic stress and associated compassion fatigue, which may affect their job performance. Research is warranted to promote a better understanding of nurses’ experiences, especially since the increase in maternal mortality has resulted in more nurses being exposed to maternal death.

Purpose:

The purpose of this study was to explore relationships between secondary traumatic stress, compassion fatigue, and compassion satisfaction of maternity …

Palliative Care Integration Into Critical Care In People With Terminal Conditions, Arielle Westfall

Honors Undergraduate Theses

Palliative care is of value to the quality of life in people with terminal conditions when initiated early. The purpose of this literature review was to identify barriers to early initiation of palliative care consultation. The secondary purpose was to examine characteristics that prompt palliative care consultation. The TLC model of palliative care was used to explore palliative care in the critical care setting in people with terminal conditions. The concepts of the model support optimal palliative care as collaborative and comprehensive, with shared decisions made by the patient, practitioners, and loved ones. A literature review was conducted to identify …

Improving Integrated Care Through An Interprofessional Communication Education Module Using Teamstepps®, Hailey Drangsholt, Natalie Truong

Doctor of Nursing Practice Projects

Background: Despite spending the most money on healthcare per capita (World Health Organization, 2020), the United States (US) has the worst health outcomes for birthing persons and newborns, measured by maternal mortality, infant mortality, and preterm birth rates. These outcomes are attributed to inadequate access to care and errors in interprofessional communication. Intervention: This quality improvement initiative implements early intervention of an interprofessional communication training using an evidence-based interprofessional collaboration frame called TeamSTEPPS®. Measures: Effectiveness of this intervention was evaluated using pre- and post- qualitative survey data gathered from participants. Outcomes: Of the 8 survey participants, 100% of …

แนวทางการพัฒนามาตรฐานขั้นต่ำด้านสภาพแวดล้อมสำหรับสถานดูแลผู้สูงอายุระยะยาว, ชนิสรา ญาณประภาศิริ

Chulalongkorn University Theses and Dissertations (Chula ETD)

ไทยได้ก้าวเข้าสู่สังคมสูงวัยโดยสมบูรณ์ ซึ่งส่งผลให้ความต้องการสถานดูแลผู้สูงอายุระยะยาวเพิ่มสูงขึ้นอย่างต่อเนื่อง ปัจจุบันมีกระทรวงสาธารณสุขบังคับใช้กฎกระทรวงกำหนดมาตรฐานด้านสถานที่ฯ พ.ศ. 2563 กับสถานดูแลผู้สูงอายุระยะยาวทั้งหมด ทั้งที่สภาพแวดล้อมของสถานดูแลผู้สูงอายุรยะยาวแตกต่างกัน ดังนั้นงานวิจัยนี้มุ่งเน้นการศึกษากฎหมายและมาตรฐานด้านสภาพแวดล้อมของไทยและต่างประเทศ รวมถึงศึกษาสภาพแวดล้อมของสถานดูแลผู้สูงอายุระยะยาวในไทย เพื่อพัฒนามาตรฐานขั้นต่ำด้านสภาพแวดล้อมสำหรับสถานดูแลผู้สูงอายุระยะยาวที่เหมาะสมกับบริบทของไทยงานวิจัยนี้ใช้วิธีวิจัยเชิงคุณภาพ (Qualitative Research) ซึ่งประกอบด้วยการศึกษาวิเคราะห์เอกสารกฎหมายและมาตรฐานที่เกี่ยวข้อง การศึกษาสังเกตสถานดูแลผู้สูงอายุระยะยาว และการสนทนากลุ่มกับผู้เชี่ยวชาญในสาขาที่เกี่ยวข้อง ผลการศึกษาพบว่าสถานดูแลผู้สูงอายุระยะยาวประกอบด้วยพื้นที่ส่วนกลาง พื้นที่พักอาศัย และพื้นที่สนับสนุน รวมถึงชี้ให้เห็นว่าไทยสามารถพัฒนามาตรฐานขั้นต่ำด้านสภาพแวดล้อมได้ด้วยการเพิ่มเติมข้อกำหนดให้ครอบคลุมมากขึ้น ผู้วิจัยจึงได้เสนอแนะมาตรฐานขั้นต่ำด้านสภาพแวดล้อมได้ทั้งหมด 12 หมวด นอกจากนี้ผู้วิจัยได้เสนอแนะว่าควรมีการแบ่งระดับมาตรฐานขั้นต่ำเป็น 3 แนวทางคือ แบ่งตามการก่อสร้าง แบ่งตามขนาดอาคาร และแบ่งตามประเภทผู้ใช้บริการ

Knowledge, Attitude, Subjective Norm, Perceived Behavioral Control, Self-Efficacy, Personality, And Intention To Providing Palliative Care For Cancer Patients Among Nursing Students: A Structural Equation Model, Numpueng Prachyakoon

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Cancer is a serious health related condition that causes suffering from pain and other distress symptoms. Palliative care (PC) is recommended as an appropriate care for patients. Nurses have an important responsibility to provide PC and nursing students should be prepared to perform these duties in the future. This study has purposes to evaluate the relationship between knowledge, attitude, subjective norm, perceived behavioral control, self-efficacy, personality, and intention to providing palliative care for patients with terminal stage cancers among nursing students, using the structural equation modeling (SEM)Method: This cross-sectional study was conducted from all nursing students who are studying …

Palliative Care And Quality Of Life Improvement: A Benchmark Study, Rebecca Daniels

MSN Capstone Projects

This project provides an overview of the standard and regular implementation of palliative care versus early implementation of palliative care in patients with chronic or terminal illnesses. Palliative care is an essential component of healthcare that focuses on improving the quality of life and providing support to patients through holistic elements to patients and their families facing chronic and terminal illnesses. With evidence-based research, many articles have been published with implementation of early palliative care showing improvement in patient and even caregiver quality of life. This project includes evidence gathered from mixed methods of systematic review of existing literature, randomized …

Poetic Representations Of Covid-19 Narratives: An Exploration Of Emotional Experiences During The Pandemic, Isha Harshe, Lindy Davidson

The Qualitative Report

In pivotal moments of history like the COVID-19 pandemic, it is critical to attend to and preserve the stories of different people experiencing the same phenomenon in their own ways. This project analyzed the public’s emotional experiences during the pandemic using methods of narrative and poetic inquiry. After reading 105 entries from the Pandemic Journaling Project, an online platform where people anonymously published journal entries reflecting on their pandemic experiences, narratives were categorized based on ten prominent emotional themes: anger, anxiety, fatigue, fear, loneliness, longing, loss, loss of control, stress, and uncertainty. Found poems were constructed for each emotion …

Impact Of The Built Environment On The End-Of-Life Journey, Kelechi Akwazie

Masters in Architecture Program: Theses

Several research studies and personal anecdotes show that home-based hospice care patients report better quality of life than their inpatient care counterparts – suggesting that the location of care/built environment is a critical component of hospice care. As a result, other research studies have attempted to provide evidence-based design recommendations for inpatient hospice facilities; however, several of these recommendations either conflict with each other or are vaguely prescribed – which may dull any attempts to implement them.

This literature review takes a unique approach to the provision of evidence-based design recommendations for inpatient hospice facilities by holistically assessing hospice care, …

Dying With Dignity: An Exploration Into The Lived Experiences Of Advanced Practice Registered Nurses Facilitating End-Of-Life Care, Dianna Lewis-Brewster

Education Doctoral

This study explored the lived experiences of advanced practice registered nurses caring for dying patients in the acute care hospital setting and how they perceive their role in the discharge process to allow for patient and family autonomy. It explored transitioning patients from the hospital to the community with an interdisciplinary team and the utilization of care homes in the community. The methodology used was a qualitative descriptive phenomenological research design. The study utilized the caring framework theories of Jean Watson’s caritas processes. The study included nine licensed advanced practice registered nurse participants from upstate New York, actively working in …