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Standardizing Initial Inpatient Palliative Care Consultations For Patients Receiving Left Ventricular Assist Devices At A Large Urban Hospital, Deborah A. Szeto
Standardizing Initial Inpatient Palliative Care Consultations For Patients Receiving Left Ventricular Assist Devices At A Large Urban Hospital, Deborah A. Szeto
Doctoral Projects
For patients with advanced heart failure (HF) ineligible for or awaiting heart transplantation, left ventricular assist device (LVAD) implantation can be considered. LVADs have helped to improve recipients’ survival rates and quality of life. However, LVAD patients are at risk for complications such as stroke, bleeding, infection, and right ventricular failure. Moreover, events such as end-stage malignancy or progression of a neurodegenerative disorder may occur. Such complications and repeated hospitalizations can pose questions about the acceptability of LVAD therapy. As such, both the Centers for Medicare and Medicaid Services and The Joint Commission require that palliative care (PC) be part …
A Quality Improvement Project To Improve Financial Sustainability Of Home-Based Palliative Care Program, Andrea L. Giffel
A Quality Improvement Project To Improve Financial Sustainability Of Home-Based Palliative Care Program, Andrea L. Giffel
Doctoral Projects
Background and Objectives: Home palliative care services are challenging to bill due to the complexity of services and competing time demands. Objectives and protocol were developed to guide coding and billing to increase Relative Value Unit generation and improve financial sustainability.
Design: A quality improvement project.
Setting: A home-based palliative care program in one health system in the Midwest.
Participants: Participants included 7 nurse practitioners.
Intervention: Coding protocol were developed, providers were educated, electronic health record audits were conducted to collect data on improvement, and feedback provided to prompt improvement.
Measurement and Analysis: Documentation of advanced care planning and billing, …
An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter
An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter
Doctoral Projects
Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.
Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …
Evidence Based Toolkit To Improve Oncology Referrals To Palliative Care, Katelyn M. Gettel
Evidence Based Toolkit To Improve Oncology Referrals To Palliative Care, Katelyn M. Gettel
Doctoral Projects
As cancer related mortality decreases, the number of patients living with cancer symptoms and the side effects of cancer treatment will continue to grow. In 2016, over 1.5 million Americans were newly diagnosed with cancer (American Cancer Society, 2016). Several major medical organizations including the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN), and the World Health Organization (WHO) endorse the integration of palliative care into cancer care (Ramchandran, 2015). Although many cancer centers report offering palliative care, this remains largely limited to inpatient services.
The stakeholders of the hospice and palliative care division of a …
End Of Life Care Practices For Patients Who Die In Intensive Care Units (Icu), Jila Ghabeljoo
End Of Life Care Practices For Patients Who Die In Intensive Care Units (Icu), Jila Ghabeljoo
Doctoral Projects
Today, one in five hospital deaths happens in the intensive care unit with the expectation of twice as many by 2030. Increasing, mortality has triggered a growing attention to end-of-life (EOL) care in the ICU. However, the lack of coveted EOL and palliative care skills creates a challenge for ICU nurses. The aim of this study was to assess the current practices of EOL care in the ICU. In this quantitative research, a retrospective chart review method was employed to analyze the collected data from a population 60 EOL patients who died in the ICU of a Southern California hospital. …
A Standardized Palliative Care Referral Workflow And Educational In-Service At An Outpatient Congestive Heart Failure Clinic, Rachel E. Cardosa
A Standardized Palliative Care Referral Workflow And Educational In-Service At An Outpatient Congestive Heart Failure Clinic, Rachel E. Cardosa
Doctoral Projects
Cardiovascular disease is a significant health issue in the US as it is the leading cause of death and most cited reason of hospitalizations in Medicare enrollees (Centers for Disease Control, 2014; Unroe et al., 2011). The American Colleges of Cardiology and the American Heart Association Guidelines recommend palliative care for all patients with heart failure (Yancy et al., 2013). The purpose of the scholarly project was to address the gaps in current practice by creating a standardized palliative care referral process and education for clinicians in an outpatient Advanced Congestive Heart Failure (ACHF) Clinic. A referral tracking process was …
Examining The Satisfaction Levels Of Hospice And Palliative Care Nurses In Education, Clinical Confidence And Knowledge Of Self Care Practice, Monica Wooldridge
Examining The Satisfaction Levels Of Hospice And Palliative Care Nurses In Education, Clinical Confidence And Knowledge Of Self Care Practice, Monica Wooldridge
Doctoral Projects
The purpose of this descriptive exploratory research study was to measure hospice and palliative care registered nurses self-reported information on end of life education and self- care practices including overall satisfaction with end of life education, self-rating of clinical confidence and knowledge of self-care practice. As no tool for measuring this was found in literature, this study included development of a new survey tool. Participants were solicited on a volunteer basis at end of life conferences and professional meetings for a period of ninety days. A total of 88 surveys were returned. Results revealed that the majority of respondents reported …