...Current Business Research Project RESEARCH AND EVALUATION Current Business Research Project Reporting Characteristics of Cancer Pain: A Systematic Review and Quantitative Analysis of Research Publications in Palliative Care Journals by Senthil P. Kumar used descriptive methods of research to discover the number of research journals of the pain experienced in cancer patients toward the end of life. The research delved into the end-of-life care journals published from 19 facilities from 2009 – 2010 (Kumar, 2011). The study involved finding the percentage of research journals for end-of- life cancer patients’ pain in comparison to actual number of research findings. The data collection methods involved a search of Journals that had terms such as hospice, end-of-life, supportive, and palliative in the titles (Kumar, 2011). A total of 19 journals included in the study, which had a total of 2600 articles researched in the study. The studies uncovered articles concerning cancer pain, of which most were categorized into ‘original articles’ and ‘review articles’. Original articles were separated to studies of quality and also of quantity. Quantitative studies were grouped according to the study designs. Once the findings of the number of articles study designs were computed, the total number of journals pertaining to end-of-life pain of cancer patients was determined. Later categorization of articles were sort into groups such as those related mostly to...
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...Patients' and End of Life Care: A Multidisciplinary Concept Analysis Jennifer Thompson UTA Analysis of Theories in Nursing Nurs 5327 Ronda Mintz-Binder, RN, MSN, DNP April 19, 2014 Terminally Ill Patients' and End of Life Care: A Multidisciplinary Concept Analysis With an aging population in our country we are facing an increasing number of patients’ that are coming to the end of their lives and are presenting with terminal illness. As life expectancy increases we are seeing more and more patent that are 65 year old and older in need of end of life care. Research and medical developments have provided a vast array of treatment options available to our patients’. After patients’ have exhausted all available treatment options for their disease processes they face the reality that their life is coming to an end. Patients’ near the end choose between quality of life over quantity of life. One service available to terminal patients’ is hospice care which offers palliative care to patients’ at the end of life. Health care providers must be able to face and appropriately care for patients’ with terminal illness and end of life care. At times it may be difficult for health care providers to face or present the truth to a patient that further treatment is futile and end of life care would be appropriate. Advanced practice nurses’ will face terminal illness and it is required of them to be able to sufficiently treat, manage, and discuss end of life care with these patients. It is...
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...The primary aim of my assignment is to look at the issue of end of life care in dialysis satellite units, as these areas tend to be nurse led units. My interest in palliative and end of life care has arisen from the growing number of poorly patients we continue to dialyse, this has proved distressing especially for the patient, who often has unmanaged symptoms and for their families, it is also upsetting for the staff involved in their care, as it is felt nobody is acting as the patients’ advocate and helping the decision to facilitate the withdrawal of what is now an ineffective and unnecessary treatment. One of the latest developments by the Government and Department of health is the concept of Advance Care Planning. I have looked at this from various perspectives and would like to be involved in introducing the process to Sheffield Kidney Institute. In 2004, the number of patients receiving renal replacement therapy in England, Scotland and Wales was 33,511, this figure is sourced from data which has been made available to them from participating renal units throughout the country, the number of patients receiving dialysis since 2000 has risen by 7% (Ansell et al 2005) with it projected to rise by a further 10 percent over the next 5 years (Ansell et al 2005). About 15-29 percent of deaths of patients with end stage renal disease results from a decision to discontinue dialysis (Davison 2006). Importantly we need to explore which patients especially those reaching...
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...to the provider (RTPd) for a more definitive hospice diagnosis. However, Debility and AFTT can and should be listed on the claim as secondary (related) conditions to support prognosis if indicated. CMS states that disallowing these diagnoses is not a new position, which comes as a surprise to most of us in the industry (otherwise why does CMS’ Medicare Administrative Contractor (MAC), Palmetto GBA, have an LCD guideline for AFTT?). Why is CMS making this clarification now? According to the Proposed Rule, CMS is taking action because of the growing number of patients admitted to hospice with these ill-defined conditions that are inherently symptom syndromes, not actual terminal diagnoses. This is born out by National Hospice and Palliative Care Organization (NHPCO) statistics, listing Debility Unspecified as the leading non-cancer diagnosis in hospice, comprising...
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...Strengths and Weaknesses……………………………………………………………….11 Timeline and Cost Considerations……………………………………………………….12 Conclusion……………………………………………………………………………….13 Concept Model………………………………………………………………..Appendix A Sample Questions……………………………………………………………..Appendix B References……………………………………………………………………………….18 Research Proposal Research Proposal Introduction Intensive care units (ICUs) were designed to provide highly skilled, lifesaving nursing care to viable patients with acute illnesses or injuries. Patients with chronic and/or terminal illness were not expected to be admitted to these units, with the possible exception of acute exacerbations of reversible complications. Patients whose care needs changed from curative to palliative were intended to be transferred out of critical care to patient care environments more suited to end-of-life care. However, as more patients become “chronically critically ill”, critical care nurses are being asked more often to provide care to patients on their deathbeds (Puntillo et al., 2001). Deciding which ICU patients are actually dying remains an extremely inexact science, and the transition to palliative care is not one easily made. ICU mortality rates are as high as 69% (Puntillo et al., 2001);...
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...Palliative and Supportive Care ~2006!, 4, 399–406. Printed in the USA. Copyright © 2006 Cambridge University Press 1478-9515006 $16.00 DOI: 10.10170S1478951506060494 Requests for euthanasia and physician-assisted suicide and the availability and application of palliative options MARIJKE C. JANSEN-VAN DER WEIDE, M.SC., BREGJE D. ONWUTEAKA-PHILIPSEN, PH.D., AND GERRIT VAN DER WAL, PH.D., M.D. Department of Public and Occupational Health and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands ~RECEIVED June 5, 2006; ACCEPTED August 27, 2006! ABSTRACT Objective: This study investigated the palliative options available when a patient requested euthanasia or physician-assisted suicide ~EAS!, the extent to which the options were applied, and changes in the patient’s wishes. Methods: In an observational study, 3614 general practitioners ~GPs! filled in a questionnaire and described their most recent request for EAS ~if any! ~n 1,681!. Results: Palliative options were still available in 25% of cases. In these cases options were applied in 63%; in 46% of these cases patients withdrew their request. Medication other than antibiotics, which was most frequently mentioned as a palliative option ~67%!, and applied most frequently ~79%!, together with radiotherapy, most frequently resulted in patients withdrawing their request. Significance of results: GPs include the availability of palliative options in their decision making when...
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...Research Critique, Part 1 Nancy I Torres Grand Canyon University: NRS – 433V March 6, 2015 Problem Statement Health care workers that are providing care for death and dying in the hospice and palliative care settings are at risk for professional compassion fatigue (PCF). Nurses dealing with the patients’ dying and the emotions of the patients’ loved ones on an ongoing basis can experience PCF. In order, to prevent becoming overwhelmed with PCF the health care workers needs to make the arrangements to take time off, and have an outlet to vent the health care workers feelings. Healthcare care workers need to be aware of the symptoms of PCF which are, anxiety, depression, apathy and intrusive thoughts. The need for nurses that specialize in caring for the death and dying may increase due to the population getting older according to the US census of 2008. Purpose and Research Questions The purpose of this study was to describe if health care workers are experiencing PCF by caring for hospice and/or palliative care population on an ongoing basis. The research questions were as followed: “Are nurses whose job it is to deal with death and dying on a continual basis at risk of developing PCF?” the other one was “What are the consequences (both physical and emotional) of hospice and palliative care nurses continually dealing with death” (Melvin, 2012)? Literature Review This was a descriptive qualitative study, the expected outcome was a comprehensive...
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...caring for palliative care patients?” Regina Nelson Governors State University Abstract Palliative Care Nurses are at risk of experiencing stressful situations related to symptom management and death. The aim of this paper is to critically examine the current stress nurses face caring for Palliative Care patients. Four Nursing Journals and one Psycho-Oncology were reviewed. There was strong evidence to support that nurse’s experience stress caring for Palliative care patients. Common concerns in the first study were caring for a dying patient; personal level, comfort of the patient, and mediating between patient and family. The second study reported physical and emotional health consequences for nurses who provide hospice and palliative care over extended periods of time. The third study of nursesreported job satisfaction, stressors, coping strategies, and support. The fourth study nurses had 10 themes that conceptualize their work that may enable palliative care workers to remain resilient and effectively buffer or moderate stressful effects. The fifth study reported routinization of care, lack of nursing staff’s availability for emotional engagement, frequent interruptions, quiet afternoons, upbeat and positive culture, and a matter of fact attitude surrounding death and dying ,were all the behaviors that “being with” could not create. Although the report showed nurses able to cope by not “being with” the overall impact is stress related to caring for Palliative care patients...
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...Enhancing end-of-life care (EoLC) is a core component of international governments’ health policies. Across the globe, nurses make significant contributions to EoLC and, at this delicate time, have the power to positively influence the health and wellbeing of those facing death. Indeed, health promotion is a core component of the nurse’s role. Originating in the UK, EoLC pathways have been adopted around the world.Their broad aim is to optimise the quality of the dying process, enabling people to ‘die well’ across care settings. This paper examines EoLC pathways in terms of promoting health and wellbeing in this discrete stage of the dying trajectory. Concepts of health and health promotion are described briefly and the idea of health-promoting palliative care and its association with a good death examined. The ensuing discussion relates to two EoLC documents. While acknowledging that much has been achieved it is argued that, despite the potential for promoting health and wellbeing, a professionally led, biomedical approach predominates, and in terms of promoting health and wellbeing at the end of life there is a pressing need for proactive advance care planning at an earlier point in the illness trajectory. Key words: End-of-life care l Care pathways l Terminal care l Health promotion Michael Allen is Staff Nurse, Chemotherapy Day Unit, Singleton Hospital, Abertawe Bro- Morgannwg University Hospital Board, Swansea, Wales; Tessa Watts is Senior Lecturer, Swansea University,...
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...is mourn and watch their loved one fade away. But there are programs out there to help not just the dying person but also the families of the dying person. Palliative care and Hospice care are two of the programs in the U.S that are tailored to medical care, pain management, and emotional and spiritual support for the patient and family. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so. Palliative care focuses on relieving symptoms that are related to chronic illnesses, such as cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s and other dementias, AIDS, Amyotrophic Lateral Sclerosis and other neurological diseases. World Health Organization defines Palliative care as “improving the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement” (“WHO”, 2013). Palliative care is accessed at any point during the course of a chronic illness regardless of life expectancy. It is typically provided through regular physician and nursing visits in an inpatient consultation service in a hospital setting. Palliative care is provided by a team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Some treatments...
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...are considered to have different palliative needs to those people diagnosed with cancer (Blackburn, 1989). It is crucial that the requirements of these patients be realized properly at their life’s conclusion and the option of palliative care be considered even though the primary cause of death in older patients is due to the vast array of problems created by advanced dementia. A variety of these problems may also be of concern as they arise from the primary disease and may include end of life care for a shorter period, communication problems due to dementia or plain misunderstanding and even chances of lack of family motivation (Blackburn, 1989). The elementary design of palliative care is to provide bodily, mental and spiritual support to the family and patient to facilitate the life quality until expiration (Australian Government Department of Health and Ageing, 2004). In the initial phases of the diseases, palliative care can be imbued with prolonging treatments (WHO, 2003) and it is not intended in any way to either accelerate or reduce the dying timeline but is meant to alleviate distress by lessening pain and other factors that result in it (WHO, 2003). It is vital that preliminary diagnosis, evaluation and therapy of pain and various other requirements such as bodily, traditional, social, spiritual and mental requirements be tended to for the accomplishment of palliative methodology (WHO, 2003). It is proper to start the palliative care in the scenario when the illness...
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...Satisfaction with Care at the End of Life Sydney Morss Dy, MD, MSc,Ã wz Lisa R. Shugarman, PhD,§ Karl A. Lorenz, MD, MSHS,§ k Richard A. Mularski, MD, MSHS,# and Joanne Lynn, MD, MA, MS,§ for the RANDFSouthern California Evidence-Based Practice Center (See editorial comments by Dr. Jean S. Kutner, pp 160–162) The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven...
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...(DNP) Projects Theses and Dissertations 1-1-2009 The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care Elizabeth Joy Gifford University of San Francisco, lgiffman1@aol.com Follow this and additional works at: http://repository.usfca.edu/dnp Part of the Nursing Commons Recommended Citation Gifford, Elizabeth Joy, "The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care" (2009). Doctor of Nursing Practice (DNP) Projects. Paper 14. This Project is brought to you for free and open access by the Theses and Dissertations at USF Scholarship Repository. It has been accepted for inclusion in Doctor of Nursing Practice (DNP) Projects by an authorized administrator of USF Scholarship Repository. For more information, please contact zjlu@usfca.edu. COMPREHENSIVE EXAM 2 Section I: Introduction Statement of the Problem Although 60% of African Americans in the United States have stated that they would want hospice care when they are dying (AARP, 2003), they only comprise 8% of all hospice enrollees (NHPCO, 2007), despite the fact that they represent 13% of the total population in this country (U.S. Census Bureau, 2008). In fact, hospice care in this nation has always been underutilized by African Americans (Connor, Elwert, Spence, & Christakis, 2008). In the San Francisco Bay Area, among Medicare-certified hospice agencies...
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...Exploring History and Theories in Euthanasia and Physician Assisted Suicide: An Annotated Bibliography The ethical considerations for euthanasia and physician assisted suicide (PAS) have been debated for decades. As this topic evolves from jurisdiction to jurisdiction, nurses must be prepared to help manage individual cases, as well as participate in shaping the end of life field. If we understand the history of practicing jurisdictions and the evolution of euthanasia and PAS, we can help develop and manage a prudent course of action. Regardless of the nurse’s personal views, this polarizing ethical issue requires a commitment to comprehending the laws of the jurisdiction and adherence to professional responsibilities. Pereira, J. (2011) Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls. Current Oncology, 18, e38-e45. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/pdf/conc-18-e38.pdf The bioethics article offers an extensive body of work that empirically analyzes the effectiveness of boundaries with euthanasia and PAS. The author contends that policy dictates mandatory reporting of euthanasia in practicing countries, but warns of several “transgressions” that occur within the current procedural structure. The main body of the article provides examples and studies to fortify the significant frequency of these transgressions. The slippery slope argument is also addressed. Where by the author documents the historical...
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...How effective communication can contribute to health, care and early years workers valuing people as individuals. All of the Migrant Helpline staff are effectively trained and know what to do automatically and so do not unnerve the client or make them feel uncomfortable by making obvious mistakes or faults if trying to communicate them. Migrant Helpline staffs also know efficient background information on each client. This is through referral forms. Referral forms are used to write down all the client details. Case booklets are filled in by all professionals, a detailed admission section and daily notes added from medical note to family details, patient’s concerns etc. case conferences held to set up support for patients going home. All written information must be sensitive and with agreement of the clients, who can see them at any time. . A follow up consultation may be needed, where questions can be answered. Stress and being upset are barriers to good communication, as is confusion and being emotionally distressed. Multi skilled professionals all work together to meet the client needs. Case workers, voluntary organizations, social workers and managements staff meet regularly to discuss and to make new plans. How client confidentiality can be maintained. Most people in caring professions and roles are aware of the need for confidentiality, but we must not assume that the client will know about this, or expect it. Some clients will have heard stories of confidentiality...
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