Palliative Care Commons^™

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 ...

Catholic Terminal Sedation-A New Framework For Providing Terminal Palliative Sedation As A Requirement In Catholic Healthcare Organizations, Noah Dimas

Graduate Student Research Symposium

The present attitudes surrounding death and dying in the United States have been trending toward the acceptance of so-called “Assisted Death” interventions at the end-of-life (EoL), specifically Physician-Assisted Suicide. The acceptance of these interventions is rooted in the notion of autonomy within the American culture of medicine that generally states a patient is allowed to request whatever medical interventions they wish. As such, legislative bodies around the United States have begun to legalize Assisted Death in response to the regularly cited desire to die peacefully and without pain from an expected terminal illness. However, for Catholic healthcare organizations, there is ...

Support For Family Members Who Are Caregivers To Relatives With Acquired Brain Injury, Janet Walker, Lourens Schlebusch, Bernhard Gaede

Journal of Mind and Medical Sciences

Objectives. Family members caring for a patient with acquired brain injury (ABI) are coping with inordinate levels of stress partially due to their lack of understanding of the neuropsychological effects of acquired brain injury in the patient. The objective of this research is to show that as the caregivers’ stress levels increase, there is an increase in suicidal ideation. This highlights the causal relationship between unhealthy stress and reduced psychological well-being in these caregivers. In addition, qualitative research evidence regarding the caregivers’ views of their main sources of stress are presented. Methods. The participants were a random sample of 80 ...

Hospice Care For The Primary Physician, Katie Mechler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Palliative vs Hospice Care
• History of Hospice Care
• Description of the Hospice Benefit
• Review of Hospice Eligibility
• Discussing Hospice with your Patients

Adapting A Traumatic Brain Injury Goals-Of-Care Decision Aid For Critically Ill Patients To Intracerebral Hemorrhage And Hemispheric Acute Ischemic Stroke, Kelsey Goostrey, Christopher Lee, Kelsey Jones, Thomas Quinn, Jesse Moskowitz, Jolanta J. Pach, Andrea K. Knies, Lori Shutter, Robert J. Goldberg, Kathleen M. Mazor, David Y. Hwang, Susanne Muehlschlegel

UMass Center for Clinical and Translational Science Supported Publications

Objectives: Families in the neurologic ICU urgently request goals-of-care decision support and shared decision-making tools. We recently developed a goals-of-care decision aid for surrogates of critically ill traumatic brain injury patients using a systematic development process adherent to the International Patient Decision Aid Standards. To widen its applicability, we adapted this decision aid to critically ill patients with intracerebral hemorrhage and large hemispheric acute ischemic stroke.

Design: Prospective observational study.

Setting: Two academic neurologic ICUs.

Subjects: Twenty family members of patients in the neurologic ICU were recruited from July 2018 to October 2018.

Interventions: None.

Measurements and Main Results: We ...

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were ...

Palliative Performance Scale As A Prognostic Tool For Patients With Dementia In Hospice, Alexandria Nasr

Scholarship in Medicine - All Papers

Objective: Palliative and hospice care have been shown to benefit people with dementia and their families. However, for patients with dementia who are nearing the end of life, hospice referral can be challenging because of the difficulty in predicting prognosis. The objective of this retrospective, exploratory study is two-fold: (1) to describe trajectories by analyzing trends in Palliative Performance Scale (PPS) scores for patients admitted to hospice with a neurocognitive disorder from time of enrollment to time of disenrollment and (2) to determine the relationship between PPS and length of stay (LOS) in hospice care.

Methods: The setting for the ...

Promotion Of Most Forms Through Education About Importance Of Advance Care Planning In Seriously Ill Patients, Nidhi More

DNP Projects

Abstract

Purpose: To establish the importance of early Advance Care Planning (ACP) and improve the utilization of Medical Orders for Scope of Treatment (MOST) forms in seriously ill patients by educating providers and nurses to identify patients who meet specified criteria. The goals of this intervention are reduction of readmissions and better quality of life for this patient population.

Methods: A quasi-experimental design was used for evaluation of an Educational intervention to promote MOST forms, Advance Directives (AD) and Palliative Care (PC) consults. A retrospective and prospective chart review was conducted to determine the number of patients who met criteria ...

Partnership Between Islam And Palliative Care At Swedish Health Services (First Hill And Cherry Hill), Hodo Mohamud

Articles, Abstracts, and Reports

INTRODUCTION  The spiritual practice of Islam is considered one of the three major monotheistic religions. There is minimal research about Palliative care and Muslim patients in both Muslim majority and Muslim minority countries. Engaging in internal assessment of palliative care provision to Muslim patients is important for quality care. This project aimed to examine gaps in Palliative needs assessment of Muslims in one institution.

OBJECTIVES Assess Swedish palliative care team’s barriers to spiritual care (SC) and baseline knowledge of Islamic influences on healthcare. Interview Muslim patients and insights from a Muslim Imam trained in chaplaincy about PC experience. Develop ...

Treatment Of Orbital Lesions Using Cyberknife Stereotactic Radiosurgery, Emily Morahan

Student Research Poster Presentations 2021

The purpose of the research done was to evaluate the use of CyberKnife Stereotactic Radiosurgery (SRS) for treating orbital lesions. Efficacy and tolerability of such treatment was analyzed with data drawn from multiple sources, regarding dose and fractionation, quality of life following treatment(s) and prognosis. CyberKnife SRS is the newest, most advanced model of radiation delivery systems, featuring a robotic arm capable of manipulating the linear accelerator into thousands of unique angles. The addition of new angles allows for a more precise concentration of radiation delivered to the lesions. In the case of optic lesions, it is crucial to ...

Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack

All Graduate Theses, Dissertations, and Other Capstone Projects

Despite advancing therapies, heart failure remains a progressive disease with high symptom burden. Advance care planning and palliative care assist in maximizing the quality of life for affected individuals. These interventions are supported by current heart failure guidelines yet application into practice is poor. The purpose of this literature review is to investigate the relationship between advance care planning and palliative care interventions on the quality of life of adults with heart failure. A search of the literature was completed between October 20^th, 2020 to November 10^th, 2020. Databases searched include Academic Search Premier, CINAHL Plus, Cochrane Database ...

Reducing Polypharmacy In Older Adults At End Of Life: The Outcome On Quality Of Life, Melissa Jenson

All Graduate Theses, Dissertations, and Other Capstone Projects

Background: Older adults at the end of life are commonly prescribed multiple medications which can lead to polypharmacy. Research has shown that optimizing medications through targeted deprescribing reduces inappropriate medications, reduces adverse effects and improves select outcomes. However, the impact of deprescribing remains uncertain--specifically whether this intervention improves quality of life (QOL). Objective: Explore polypharmacy in older adults at the end of life examining outcomes of deprescribing on the QOL. Methods: A systematic literature search using Academic Search Premier, CINAHL, Medline, JSTOR and Nursing and Allied Health Database was conducted between October 2020 to November 2020. Select articles published between ...

The Use Of Life-Like Robotic Animals In The Acute Care Setting To Assist In The Care Of Patients With Dementia, Abby Denby

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The purpose of this pilot project was to describe the effect of life-like robotic animals on the nurses’ ability to provide care, patients’ level of agitation, use of antipsychotic medications, restraint and sitter use for patients with dementia in an acute care setting. Nurses report challenges and feelings of helplessness while caring for patients with dementia. Dementia may cause depression, agitation, aggression (physical or verbal) and a decrease quality of life. Animal Assisted Therapy (ATT) is a growing therapy in many healthcare settings but there is a lack of literature specifically related to the use of AAT in the acute ...

Earlier Palliative Care Referrals For Nephrology Patients, Jerold Cohen

Doctor of Nursing Practice (DNP) Projects

Palliative care prevents and relieves suffering through the early identification and treatment of pain and other symptoms, which can be physical, psychosocial, or spiritual (World Health Organization, 2018). It is usually considered a service provided to oncology patients and has positively impacted their treatment. However, it is not as common for many other diseases where the patient would benefit from palliative care involvement. Presently, if palliative care is offered to nephrology patients, it is after they have started dialysis and are having second thoughts whether to continue this treatment plan as it has either become less effective or is interfering ...

Bhsf Palliative Care: Covid-19 Response, Ana Viamonte Ros, Nivia Ruiz, Brenda Daniels, Mayra Villalba

Nursing & Health Sciences Research Journal

No abstract provided.

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with ...

Heroism And Hypocrisy: Seeing Our Reflection With 2020 Vision., Ira Byock

Articles, Abstracts, and Reports

No abstract provided.

Conference Proceedings: Aurora Scientific Day 2020

Journal of Patient-Centered Research and Reviews

Abstracts published in this supplement were among those presented at the 46th annual Aurora Scientific Day research symposium, held virtually on May 20, 2020. The symposium provides a forum for describing research studies conducted by faculty, fellows, residents, and allied health professionals affiliated with Wisconsin-based Aurora Health Care, a part of the Advocate Aurora Health health system, which publishes the Journal of Patient-Centered Research and Reviews.

Spiritual And Psychosocial Palliative Care In A Rural Ontario Town: An Exploratory Study Of Patient Needs And Provider Experiences, Erynn M. Monette

Electronic Thesis and Dissertation Repository

This exploratory qualitative study identified spiritual and psychosocial palliative care needs in one rural Eastern Ontario town, referred to as the pseudonym “Duffy’s Hill.” Six qualitative interviews with health care providers gathered insights, ideas, and stories related to the provision of spiritual and psychosocial palliative care in Duffy’s Hill. Participant responses were analyzed for shared values, beliefs, ideas, practices, and norms in providing this care to determine if the distinct needs observed could be attributed to cultural particularities in Duffy’s Hill. Results found that participants viewed Duffy’s Hill as distinct from urban contexts in nature of ...

Clinical Decision Science Requires Doctors To Examine Their Own Inner World, Janice C. Lau

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the importance of preparation for difficult conversations with patients and their families after finding herself unprepared to compassionately communicate a clinical decision for a pediatric patient.