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Deprescribing In The Hospice Population, Who Is Eligible And Who Is Agreeable: A Quality Improvement Project, Ashlee Nicole Smith

Doctor of Nursing Practice Final Manuscripts

Current evidence recommends and supports deprescribing medications to reduce polypharmacy in the hospice population. The project aim was to determine accurate percentages of deprescribing at three time periods: before hospice admission, at hospice enrollment, and four weeks post hospice enrollment. This project was a retrospective review of the medication administration record (MAR) of patients admitted into Sharp Hospice from a Sharp Healthcare facility. Sharp Hospice, in California, USA, admitted 164 patients during August 2020. Of those, 34 patients were eligible for inclusion in this retrospective quality improvement review. Prior to discharge from a Sharp facility, the percentage of target medications …

Managing End-Of-Life Pain Using A Rectal Medication Administration Device, Yen T. Kim

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project was to improve end-of-life pain management among hospice patients using a rectal medication administration device (RMAD).

Background: Approximately 1.5 to 1.6 million patients received hospice services in 2013 (National Hospice and Palliative Care Organization, 2013), and almost 75% of terminally ill patients experience pain during the dying process (Fink & Gates, 2010). Patients are often unable to tolerate oral pain medications at the end of life. Rectal administration of medication is an appropriate alternative for these patients. The rectal route has several benefits including low cost, consistent and predictable absorption of medications, ease of …