Palliative Care Commons^™

Challenges In Teaching Palliative Care Module Virtually During Covid-19 Era, Shanaz Hussein Cassum, Khairunnisa Mansoor, Amina Hirji, Amber David, Amina Aijaz Khowaja

School of Nursing & Midwifery

With the COVID-19 pandemic hitting the global community, routine activities of universities, offices, and industries have been hindered. People are being forced to rethink the ways of working virtually from home for providing education, business, and health services in this social distancing during the COVID era. This sudden shift also posed challenges of online teaching in a private university, in urban Karachi, Pakistan. The Aga Khan University, School of Nursing and Midwifery recently conducted an online palliative care module using a virtual learning environment and Microsoft Teams for Trainee Nurse Interns. Although the first experience of online teaching and learning …

Perinatal Palliative Care Birth Planning As Advance Care Planning., Donnamaria E. Cortezzo, Kelstan Ellis, Amy Schlegel

Manuscripts, Articles, Book Chapters and Other Papers

Purpose of Review: A significant number of pregnancies are complicated by a fetus with a life-limiting diagnosis. As diagnoses are made earlier in the pregnancy, families experience anticipatory grief and are faced with navigating goals of care for a baby that has yet to be born. With the support of the care team, families can begin to grieve, plan, and make meaningful memories during the duration of the pregnancy, the birth of their baby, and life of the child. Creating a palliative care birth plan, which expands beyond the traditional concept for delivery planning to include prenatal, perinatal, and neonatal …

Randomized Control Trial Of Advanced Cancer Patients At A Private Hospital In Kenya And The Impact Of Dignity Therapy On Quality Of Life, John Weru, Miriam Gatehi, Alice Musibi

Internal Medicine, East Africa

Background: Palliative care is a modality of treatment that addresses physical, psychological and spiritual symptoms. Dignity therapy, a form of psychotherapy, was developed by Professor Harvey Chochinov, MD in 2005.The aim of the study was to assess the effect of one session of dignity therapy on quality of life in advanced cancer patients.

Methods: This was a randomized control trial of 144 patients (72 in each arm) randomized into group 1 (intervention arm) and group 2 (control arm). Baseline ESAS scores were determined in both arms following which group 1 received Dignity therapy while Group 2 received usual care only. …

Clinical And Socioeconomic Predictors Of Palliative Care Utilization, Rohan Reddy Tummala, Andrew Manuel De Jesus, Natasha Danielle Tillett, Jeffrey Scott Nelson, Christine Marie Lamey

Longitudinal Scholar's Project

INTRODUCTION: Palliative care continues to gain recognition among primary care providers, as patients suffering from chronic conditions may benefit from use of this growing service.

OBJECTIVES: This single-institution quality improvement study investigates the clinical characteristics and socioeconomic status (SES) of palliative care patients and identifies predictors of palliative care utilization.

METHODS: Retrospective chart review was used to compare clinical and SES parameters for three groups of patients: (1) palliative care patients who attended at least one visit since the inception of the University Clinical Health Palliative Care Clinic in Memphis, TN in October 2018 (n = 61), …

Association Of Palliative Care Consultation With Advance Directive Completion For Patients Admitted With An Acute Heart Failure Exacerbation, Michelle Crispo, Doug Sawyer, Kathleen Fairfield, Rebecca N. Hutchinson

Journal of Maine Medical Center

No abstract for research letter

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 …

Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Nienke Sahelijo Bsn, Rn, Dnp-Fnp Student, Kori Fitzgerald Dnp, Fnp-C, Joseph F. Burkard Dncs, Crna

Doctor of Nursing Practice Final Manuscripts

Objectives: Palliative care services constitute a vital part of the oncology treatment plan. Much of the suffering associated directly with cancer itself or as a result of treatments can be mitigated with the early incorporation of palliative services. Unfortunately, access to palliative care remains elusive due to a lack of qualified providers. This evidence-based project was implemented in an effort to address gaps in care for advanced cancer patients. The goal was to provide telehealth visits for follow-up of stable patients to manage symptoms and psychosocial challenges with equivalent or improved satisfaction as compared to their last in-office visit …

The Anti-Epileptic Dilemma – A How To For Transitioning Patients On Seizure Medications To Hospice, Erin Kelly, Do, John Liantonio, Md, Mba, Hdmc, Debra Vermette, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Objective

We propose an approach to antiepiletics in hospice that includes the evaluation of steroids, medication options, pharmacy consultation and seizure breakthrough plan so that we meet the goals of the patient on hospice.

To Anticoagulate Or Not: Decision Making Surrounding Anticoagulation In Patients In Hospice And Palliative Care Programs, Erin Kelly, Do, John Liantonio, Md, Mba, Hdmc, Debra Vermette, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Objectives

• Describe the current guidelines for CAT treatment. - Assess risk factors for bleeding and thrombosis in cancer patients and risk/benefits of anticoagulation.
• Recognize the need for individualized anticoagulation plans in order to make informed decisions that may differ from the guidelines.
• Propose anticoagulation in hospice if it will achieve the goals of the patient.

Increasing Palliative Care Team Involvement In Pediatric Oncology Patients, Sana Farooki

Research Days

No abstract provided.

Goals Of Care 101, Alexandra Evans, Do, Adam Pennarola, Md, Elham Siddiqui, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Hospice and Palliative Medicine - Alexandra Evans, DO

Approaching Goals of Care in the Outpatient World - Elham Siddiqui, MD

Inpatient Goals of Care Discussion - Adam Pennarola, MD

Incorporating A Clinical Pharmacist In An Outpatient Palliative Care Team, Crystal Rim, Sharon Leigh, Linda Desitter, Mary Grant, Dana Nguyen

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2020

Title: Incorporating a clinical pharmacist in an outpatient palliative care team

Crystal Rim, PharmD; Sharon Leigh, PharmD, BCPS; Linda De Sitter MD, MPH; Mary Grant, ANP; Dana Nguyen, PharmD

Palliative care is a growing field in medicine that focuses on delivering care that improves quality of life for patients with serious illnesses. Often, the goals of palliative care differ from traditional goals of medicine. Currently, there is limited data demonstrating the integration of pharmacists in the palliative care setting. The purpose of this quality improvement is to evaluate the clinical pharmacist’s role within an outpatient palliative care team when performing …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Extra Medullar Granulocytic Sarcoma: A Case Report Of An Exceptional Localization, Bouhani Malek, Sakhri Saida, Jaidane Olfa, Adouni Olfa, Chargui Riadh, Rahal Khaled

Journal of Mind and Medical Sciences

Granulocytic sarcoma is a rare type of tumor composed of extramedullary immature cells. The breast location is very rare; it accounts for less than 8% of cases. The present study reports the case of a 36-year-old female with a medical history of myelodysplastic syndrome. She was referred because of a lump in the left breast. We have diagnosed a case of granulocytic sarcoma of the breast by core biopsy. Histology and immunohistochemistry showed hypercellular smears with immature myeloid cells. The blast cells were myeloperoxidase positive.

The patient underwent a lumpectomy. Five months later, she developed a contralateral recurrence, treated by …

Compassion And Suppression In Caregivers: Twin Masks Of Tragedy And Joy Of Caring, Emanuele Maria Merlo, Sean M. Mcnabney, Fabio Frisone, Federica Sicari, Mihai Paunica, Catalina Motofei, Salvatore Settineri

Journal of Mind and Medical Sciences

Background: Compassionate caregiving is a critical skill for workers among the helping professions, but the degree of empathy required by caregivers can place high demands on their mental and emotional resources. While many professionals employ successful coping strategies to mitigate these stressors, others experience compassion fatigue or burnout from emotional exhaustion. The objective of this research was to evaluate the relationships between caregivers’ demographic/career variables, compassion satisfaction, compassion fatigue, and psychodynamic defense mechanisms such as suppression, repressive function, regression in the service of the Ego, and rationalization. Methods: Participants were 250 caregivers with 178 (71,2%) women and 72 men (28,8%) …

The Serine/Threonine Protein Kinase (Akt)/ Protein Kinase B (Pkb) Signaling Pathway In Breast Cancer, Daniela Miricescu, Camelia Cristina Diaconu, Constantin Stefani, Ana Maria Alexandra Stanescu, Alexandra Totan, Ioana Ruxandra Rusu, Ovidiu Gabriel Bratu, Dan Spinu, Maria Greabu

Journal of Mind and Medical Sciences

According to statistical data published in 2019, breast cancer is among the leading causes of death in women worldwide. The serine/threonine kinase (AKT) or protein kinase B (PkB) signaling pathway is activated by phosphorylation processes, which further is associated with cell growth, proliferation, and survival, but also with activation of glucose metabolism. Mutations of the AKT signaling pathway components (especially PI3KCA and PTEN) have been observed in breast cancer patients, which are associated with resistance to hormonal treatment. Many clinical trials are testing the effect of AKT inhibition in order to block the growth and proliferation of breast cancer cells. …

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, …

Blood Cancers And Oral Health, Silvia Spivakovsky Dds, Gwen Nichols Md, Laura Romundstad Crnp, Msn, Elizabeth Kitlas Lmsw

The Journal of the Michigan Dental Association

Managing Blood Cancer Patients' Oral Complications: Preventive Strategies during and after Treatment

Blood cancers, encompassing leukemia, lymphoma, myeloma, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN), bring complex challenges to patient management due to their impact on hematopoiesis, immunity, and overall health. This review focuses on equipping dental practitioners with essential insights into preventing and managing intricate oral manifestations during and after treatment. Patient care strategies are outlined for leukemia subtypes such as acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML), emphasizing the need for tailored dental approaches. In lymphomas encompassing Hodgkin …

Oral Complications In Cancer Patients: A Review Of Practical Interventions In The Dental Setting, Caroline Bissonnette Dds, Kristin Mcnamara Dds, John Kalmar Dmd, Phd

The Journal of the Michigan Dental Association

Cancer prevalence in the United States is significant, with an estimated 40% of the population experiencing this diagnosis at some point in their lives. In 2020 alone, 1,806,590 new cancer cases were projected, encompassing 53,260 cases involving oral and oropharyngeal malignancies. Amidst barriers like financial constraints and irregular dental visits (highlighted by a 2014 American Dental Association survey indicating that 32.3% of the general population avoids yearly dentist appointments), patients battling cancer often encounter not just routine dental needs, but the intricate challenges arising from their malignancy and treatments. Dental professionals, pivotal in orchestrating optimal treatment strategies for cancer patients, …