Literature Review
The value of a DNP degree: Translating your knowledge into nursing practice
06/17/24 at 02:00 AMThe value of a DNP degree: Translating your knowledge into nursing practice Delaware State Nurses Association; by Karen L. Pickard, DNP, RN, CNE, NEA-BC; 6/13/24The Doctor of Nursing Practice (DNP) degree has gained traction in the United States over the last twenty-two years. Nurses who specialized in clinical practice and held an advanced practice license supported the development of the DNP degree as an alternative to a terminal degree specialized in research science and academia, the Ph.D. ... Having a broader perspective related to the business of healthcare while understanding the clinical challenges nurses face at the bedside gives a DNP-prepared nurse opportunities to present information and solutions through a different lens. Opportunities on boards, advisory committees, and professional organizations have become vast, ...Editorial Note: Does your organization have DNP professionals whose skills you are under-utilizing? Do you have talented, motivated nurses who would benefit from a DNP career ladder plan? Share this article. What career ladder options and support do your Human Resources systems provide?
Celebrate CNA Week Toolkit: June 13-19, 2024
06/17/24 at 02:00 AMCelebrate CNA Week Toolkit: June 13-19, 2024 NAHCA - The CNA Association; retrieved from the internet 6/14/24 This year, CNA Week is from June 13th to June 19th. With the theme of "We'll Be There For You," NAHCA created this toolkit for CNAs and for the skilled nursing centers, assisted living communities, and staffing and home health agencies they work for so that everyone can celebrate, recognize, and pay their respects to the incredible work that the nearly 1 million-strong contingent of frontline heroes does everyday for elders and people with disabilities. Editor's Note: We apologize for the late date of this notice, as it has not been showing up in our many newsfeeds. That fact illustrates how healthcare too often neglects our valued Certified Nursing Assistants. Are you doing something special to thank your CNA's? If you post something on your website to honor your CNA's, please let me know via jberger@hospicepalliativecaretoday.org. Thank you.
How fraudulent hospices evade regulators
06/16/24 at 03:55 AMHow fraudulent hospices evade regulators Hospice News; by Jim Parker; 6/5/24A slew of fraudulent hospices in California are dodging consequences by shuffling patients around between provider numbers. That’s according to multiple sources who spoke with Hospice News, expressing their concerns about patterns of fraud continuing even as government regulators crack down on the sector. Since 2021, numerous media and government reports have emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona. Despite the best efforts of regulators and law enforcement, hospice leaders are concerned that many bad actors are slipping through the cracks. ...
The Aging Revolution: Growing old in America becoming more dignified, but with senior population booming, is nation’s health system prepared?
06/16/24 at 03:50 AMThe Aging Revolution: Growing old in America becoming more dignified, but with senior population booming, is nation’s health system prepared?BusinesssWire; 6/4/24A half-century after renowned gerontologist, psychiatrist and author Dr. Robert Butler ridiculed the nation’s medical establishment for ignoring the suffering of older Americans, Northwell Health today announced the publication of The Aging Revolution: The History of Geriatric Health Care and What Really Matters to Older Adults, which chronicles the significant advancements made in improving the physical and emotional health of the nation’s rapidly aging population.
Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leaders
06/16/24 at 03:45 AMActing now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ...
Hope in oncology: Where art and science collide
06/16/24 at 03:40 AMHope in oncology: Where art and science collide Medscape; by Sharon Worcester, MA; 6/12/24 Carlos, a 21-year-old, laid in a hospital bed, barely clinging to life. Following a stem cell transplant for leukemia, Carlos had developed a life-threatening case of graft-vs-host disease. But Carlos' mother had faith. "I have hope things will get better," she said, via interpreter, to Richard Leiter, MD, a palliative care doctor in training at that time. "I hope they will," Leiter told her. "I should have stopped there," said Leiter, recounting an early-career lesson on hope during the ASCO Voices session at the American Society of Clinical Oncology (ASCO) 2024 annual meeting. "But in my eagerness to show my attending and myself that I could handle this conversation, I kept going, mistakenly." ... Carlos' mother looked Leiter in the eye. "You want him to die," she said. ...Editor's Note: Click on the title's link to continue reading this insightful reflection and discussion about the importance of "hope." Engage your oncology/palliative/hospice chaplains (hopefully CPE trained and Board Certified) with your medical team members to explore this core belief in "hope." Alert: AI referrals for palliative and hospice care are increasing exponentially. Clinicians must be sensitive to the human dimensions and dynamics of "hope" (which shift and change), and not be driven just by technological data.
Mapped: The highs and lows of the world’s happiness landscape
06/16/24 at 03:35 AMMapped: The highs and lows of the world’s happiness landscapeBigThink.com (originally posted in 1440 Daily Digest; by Frank Jacobs; 6/3/24The Gallup World Poll reveals regional peaks and valleys of happiness across all of the continents. At a glance, we see that happiness levels are relatively high across the Americas, in Europe and Oceania, and generally lowest across Africa and South Asia. In North America, Canada (6.9) came out on top, happier than the U.S. and Mexico (both 6.7). The least happy country in North America is the Dominican Republic (5.8) — perhaps unfairly, as its bad-to-worse neighbor Haiti wasn’t surveyed.
NPHI: Increase scrutiny of PE hospice transactions
06/16/24 at 03:30 AMNPHI: Increase scrutiny of PE hospice transactions Hospice News; by Jim Parker; 6/11/24 Federal regulators should increase scrutiny of private equity activity in the hospice space, according to the National Partnership for Healthcare and Hospice Innovation (NPHI). NPHI is a membership organization comprising more than 100 nonprofit, community-integrated hospice and palliative care providers from 38 states and the District of Columbia. The organization recently submitted comments in response to a Request for Information from the U.S. Department of Justice (DOJ), Department of Health and Human Services (HHS) and the Federal Trade Commission (FTC).
Red River Valley expands services for dual-eligible populations
06/16/24 at 03:25 AMRed River Valley expands services for dual-eligible populationsHospice News; by Holly Vossel; 6/11/24North Dakota-based Hospice of the Red River Valley is focused on expanding its home- and community-based services among dual-eligible Medicare and Medicaid populations in need of greater support. Serious and terminally ill patients in lower socioeconomic and underserved regions face several competing challenges in accessing health care, according to Tracee Capron, executive director at Hospice of the Red River Valley. Developing a sustainable care delivery model that better addresses unmet needs among patients and their families requires significant investment, Capron said.
Stepped palliative care for patients with advanced lung cancer: A randomized clinical trial
06/16/24 at 03:20 AMStepped palliative care for patients with advanced lung cancer: A randomized clinical trialJAMA; by Jennifer S. Temel, MD, Vicki A. Jackson, MPH, MD, Areej El-Jawahri, MD, Simone P. Rinaldi, MSN, ANP-BC, ACHPN, Laura A. Petrillo, MD, Pallavi Kumar, MD, Kathryn A. McGrath, MD, Thomas W. LeBlanc, MD, Arif H. Kamal, MD, Christopher A. Jones, MD, Dustin J. Rabideau, PhD, Nora Horick, MS, Kedie Pintro, MS, Emily R. Gallagher Medeiros, RN, Kathryn E. Post, PhD, RN, ANP-BC, Joseph A. Greer, PhD; 6/24A stepped-care model, with palliative care visits occurring only at key points in patients’ cancer trajectories and using a decrement in QOL to trigger more intensive palliative care exposure, resulted in fewer palliative care visits without diminishing the benefits for patients’ QOL. While stepped palliative care was associated with fewer days in hospice, it is a more scalable way to deliver early palliative care to enhance patient-reported outcomes.Publisher's note: This article was reference earlier this week in Palliative care for cancer patients is found to be as effective given virtually as in person.
Geriatric End-of-Life Screening Tool prediction of 6-month mortality in older patients
06/16/24 at 03:15 AMGeriatric End-of-Life Screening Tool prediction of 6-month mortality in older patientsJAMA Open Network; by Adrian D. Haimovich, MD, PhD, Ryan C. Burke, PhD, MPH, Larry A. Nathanson, MD, David Rubins, MD, R. Andrew Taylor, MD, MHS, Erin K. Kross, MD, Kei Ouchi, MD, MPH, Nathan I. Shapiro, MD, MPH, Mara A. Schonberg, MD, MPH; 5/31/24In this prognostic study of 82,371 ED encounters within a tertiary care emergency department, the Geriatric End-of-Life Screening Tool (GEST) performed robustly on external validation, identifying 11.6% of the population as having a 30% or greater mortality risk. Compared with serious illness diagnoses, GEST provided a greater net benefit as a screening tool using decision curve analysis. The findings of this prognostic external validation study highlight the opportunity to use pragmatic, prognostic electronic health record algorithms to identify older adults in the emergency department for end-of-life care interventions.Publisher's Note: See related article posted earlier this week from McKnight's Long-Term Care News, Screening tool predicts older adults’ need for end-of-life care intervention.
National Nurses Honor Guard Coalition
06/16/24 at 03:10 AMNational Nurses Honor Guard CoalitionJournal of Hospice and Palliative Nursing; by Betty Ferrell; 6/24As hospice and palliative care nurses, we are very familiar with the importance of rituals at the end of life or after death, which helps us to honor this sacred time. We know that funeral or memorial services offer a time to honor lives and to provide comfort to families. But how often do we pause to honor our own nursing colleagues for their lives of service?I recently learned of an incredible organization, the National Nurses Honor Guard Coalition, which is doing just this—honoring nurses through participation in their funeral services to celebrate these lives well lived and lives dedicated to our profession. ... Hearing about the Honor Guard Coalition brought tears to my eyes to think about this incredible tribute to nurses.Publisher's Note: Thanks for writing about this important group Betty! I also recently learned about the National (and state-specific) Nurses Honor Guard Coalition at the Nebraska Hospice & Palliative Care Association annual conference. A great group with a fantastic mission.
Pride Month 2024: LGBTQ+ Resources for Hospice & Palliative Care Organizations
06/16/24 at 03:05 AMPride Month 2024: LGBTQ+ Resources for Hospice & Palliative Care OrganizationsCompiled from various search engines for our newsletter's readers
Sunday newsletters
06/16/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!If you enjoy this newsletter, please share it with colleagues - they can subscribe (for free) here!If interested in becoming a sponsor, please contact us here!
Today's Encouragement
06/16/24 at 03:00 AMI’m practicing the discipline of not having to have the last word. ~Dallas Willard
U.S. Rep. Beth Van Duyne: Crack down on hospice fraud
06/16/24 at 03:00 AMU.S. Rep. Beth Van Duyne: Crack down on hospice fraud Hospice News; by Jim Parker; 6/12/24 Rep. Beth Van Duyne, (R-Texas) has emerged as one of Washington’s most vocal advocates for hospice providers in Congress. ... Van Duyne was among a group of lawmakers that wrote to CMS Administrator Chiquita Brooks LaSure last month requesting updates on the agency’s battles against fraudulent providers, as well as a U.S. Government Accountability Office (GAO) report on quality issues in the hospice space. Hospice News spoke with Rep. Van Duyne in Washington D.C. on congressional efforts to root out fraud and where they should go next.
Geriatric conditions and healthcare utilization among older adults living in subsidized housing
06/15/24 at 03:35 AMGeriatric conditions and healthcare utilization among older adults living in subsidized housingJournal of the Americal Geriatric Society; by Sarah E Kler, L Grisell Diaz-Ramirez, Kira L Ryskina, Sun Young Jeon, Kanan Patel, Thomas K M Cudjoe, Christine S Ritchie, Krista L Harrison, W John Boscardin, Rebecca T Brown; 6/24Older adults living in subsidized housing have higher hazards of hospitalization and nursing facility utilization compared to those in the general community. Housing-based interventions to optimize aging in place and mitigate risk of nursing facility utilization should consider risk factors including functional impairment and dementia.
Effects of a discourse intervention on end-of-life knowledge and attitudes of Bachelor of Science in Nursing students
06/15/24 at 03:30 AMEffects of a discourse intervention on end-of-life knowledge and attitudes of Bachelor of Science in Nursing studentsJournal of Hospice & Palliative Nursing; by Haynes, Jayme G. PhD, RN, Dingley, Catherine PhD, RN, FAAN; 6/24The findings indicated increased knowledge and positive attitude changes. This study supports the value of theory-based educational interventions, like a discourse intervention, to enhance effective pedagogy when addressing emotionally laden content such as end-of-life care. This study may have also given a glimpse of how a global pandemic may affect end-of-life knowledge and attitudes.
Loneliness, psychological distress, and the moderating effect of positive aspects of caregiving among cancer caregivers
06/15/24 at 03:25 AMLoneliness, psychological distress, and the moderating effect of positive aspects of caregiving among cancer caregiversSupportive Care in Cancer; by JoAnn Jabbari, Kyle A Pitzer, Keisha White Makinde, Jacquelyn J Benson, George Demiris, Debra Parker Oliver, Karla T WashingtonThe results of this study shed new light on the relationship between loneliness and symptoms of psychological distress experienced by family caregivers of cancer patients, providing a better understanding of the impact that recognition of positive aspects of caregiving has on the association between loneliness and psychological distress symptoms. Our findings emphasize the importance of targeting family caregiver loneliness in order to reduce psychological distress among family caregivers of cancer patients.
NeoTalk: Communication skills training for neonatal clinicians
06/15/24 at 03:20 AMNeoTalk: Communication skills training for neonatal cliniciansAmerican Journal of Hospice and Palliative Medicine; by Katherine F. Guttmann, MD, Malorie Meshkati, MD, Julia Frydman, MD, Cardinale B. Smith, MD, PhD, Lindsay Dow, MD, and Andrea S. Weintraub, MD; 6/24A multi-disciplinary cohort of NICU providers endorsed increased confidence in key communication skills but not increased skill application 2-months post-course completion. While a single course can successfully teach skills, additional exposure may be necessary to build new communication habits. Our experience developing NeoTalk helped elucidate some of the ways in which conversations about seriously ill infants may be different from conversations about seriously ill adults.
Training Senior Companion Volunteers to identify and report adult abuse, neglect, and exploitation
06/15/24 at 03:15 AMTraining Senior Companion Volunteers to identify and report adult abuse, neglect, and exploitationJournal of Applied Gerontology; by Jessica Bibbo, Courtney Reynolds, Farida Kassim; 6/24Elder abuse is a national public health challenge that can have dire consequences for the older adults who experience it in any form. The Senior Companion Program presents a unique opportunity to address this public health challenge. An in-person training for Senior Companion volunteers across Ohio on how to recognize and report elder abuse was developed, implemented, and evaluated prior to the COVID-19 pandemic. ... Training older adult volunteers working with other community-dwelling adults is likely a valuable strategy to educate and protect against elder abuse.Publisher's Note: I wonder if similar training could be incorporated into hospice voluteer, social worker, etc., training?
Less care at higher cost - The Medicare Advantage paradox
06/15/24 at 03:10 AMLess care at higher cost - The Medicare Advantage paradoxJAMA Internal Medicine; by Adam Gaffney, MD, MPH, Stephanie Woolhandler, MD, MPH, David U. Himmelstein, MD; 6/24Celebrating a Medicare Advantage (MA) milestone—enrollment in those private plans surpassed 30 million—the health insurance industry’s trade group proclaimed MA “a good deal for members and taxpayers.” The first part of that claim is debatable, while the second part is false. Medicare Payment Advisory Commission (MedPAC), the nonpartisan agency reporting to Congress, recently estimated that MA overpayments added $82 billion to taxpayers’ costs for Medicare in 2023 and $612 billion between 2007 and 2024.Publisher's Note: "You're getting less care, but at least it costs more" is right in line with my mantra "I may be old, but at least I'm slow"...
Patterns of national emergency department utilization by fee-for-service Medicare beneficiaries with dementia
06/15/24 at 03:05 AMPatterns of national emergency department utilization by fee-for-service Medicare beneficiaries with dementiaJournal of the American Geriatrics Society; by Jason K Bowman, Christine S Ritchie, Kei Ouchi, James A Tulsky, Joan M Teno; 6/24Persons with ADRD frequently use the ED-particularly those with recent hospitalizations, rehab/SNF stays, or home health use-and may benefit from targeted interventions during or before the ED encounters to reduce avoidable utilization and ensure goal-concordant care.
Palliative care in early dementia: A scoping review
06/15/24 at 03:00 AMPalliative care in early dementia: A scoping reviewJournal of Pain and Symptom Management; by Karen de Sola-Smith, Joni Gilissen, Jenny T van der Steen, Inbal Mayan, Lieve Van den Block, Christine S Ritchie, Lauren J HuntThe literature on palliative care in early dementia is sparse. Future studies should focus on assessment tools for optimizing timing of palliative care in early dementia, gaining better understanding of patient and family needs during early phases of disease, and providing training for providers and families in long-term relationships and communication around goals of care and future planning.
“I should’ve been able to decide for myself, but I didn’t want to be left alone.” A qualitative interview study of clients’ ethical challenges and norms regarding decision-making in gender-affirming medical care
06/15/24 at 03:00 AM“I should’ve been able to decide for myself, but I didn’t want to be left alone.” A qualitative interview study of clients’ ethical challenges and norms regarding decision-making in gender-affirming medical careJournal of Homosexuality; by Karl Gerritse, MD, MA, PhD, Casper Martens, MSc, Baudewijntje P.C. Kreukels, PhD, Marijke A. Bremmer, MD, Fijgje de Boer, PhD, Bert C. Molewijk, PhD; 6/24[The Netherlands] This qualitative study aimed to map and provide insight into the ethical challenges and norms of adult transgender and gender diverse (TGD) clients in gender-affirming medical care (GAMC). By doing so, we seek to make an empirical and constructive contribution to the dialogue on and moral inquiry into what good decision-making in GAMC should entail. ... Our findings highlight divergent and dynamic decisional challenges and normative views— both within individual clients and among them. We conclude that there is no single ideal model of good decision-making in GAMC and argue that elucidating and jointly deliberating on decisional norms and challenges should be an inherent part of co-constructing good decision-making.