Literature Review

New data reveals the hidden costs of workplace violence in healthcare Perceptyx; by Ellen Lovell, PhD and Stephanie Schloemer, PhD; 1/17/25 Workplace violence has become an impossible-to-ignore crisis in healthcare, threatening the safety of medical professionals, patients, and institutions. The severity and frequency of these incidents have reached alarming levels, demanding immediate attention and action. ... The human cost is staggering.  ... While our research confirms the widespread nature of safety concerns in healthcare, a deeper analysis reveals significant variations across different healthcare environments and roles. This granular view helps us understand where intervention is most urgently needed. Editor's note: Although "hospice settings reported the lowest agreement at 54%," this statistic should be considered too high for comfort. Actions need to be taken to reduce it. From your professional leadership role, examine the importance of protecting hospice professionals' safety--typically in home settings--and through moments such vulnerable, emotional, conflicted times within families. What can your agency improve?

Introduction: ‘Those who have made death their life’The Daily Yonder - Keep It Rural; by Hannah Clark; 1/15/25 Hannah Clark spent six months riding along with the nurses and certified nursing assistants (CNAs) of Hearth Hospice who provide in-home care to those living in Northwest Georgia and Southeast Tennessee. These hospice workers often drive up to a hundred miles a day to visit a handful of patients scattered across the Appalachian landscape in both rural towns and urban centers. What will follow this introductory essay is her photo reportage in three parts, documenting what she has witnessed accompanying these caregivers. The intimate portraits and vignettes show tender moments at different stages towards the end of one’s life. Their beauty lies in the companionship Clark captured in moments of need and vulnerability. 

What Gen Z wants from employers Becker's Hospital Review; by Kristin Kuchno; 12/16/24 Each new generation entering the workforce brings unique challenges for management, and Generation Z is no exception. Leaders may find themselves puzzled by what Gen Z workers want from their employers and what drives their retention. This generation includes individuals born between 1997 and 2012, making the oldest members 27 years old. [Here] are 16 common priorities of Gen Z workers, as reported by Becker's in 2024: 1. Company culture ... 2. Team dynamics ... 3. Career paths ... 4. Mental health resources ... 5. Student loan repayment options ... 6. Full-time commitment ... 7. Wise feedback ... 8. Work-life balance ... 9. Purpose-driven roles ... 10. Flexible work ... 11. Growth opportunities ... 12. Feedback and validation ... 13. Retention by role ... 14. AI skepticisim ... 15. Timely pay ... 16. Authenticity ...

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

Palliative care may improve quality of life for stroke survivors and their family members American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

How hospice CNAs provide comfort in end-of-life care Intelligent Living; by Jennifer Barns; 12/8/24 End-of-life care is one of the most challenging yet meaningful services that healthcare professionals can offer. During such a delicate time, the role of a hospice CNA becomes essential. ... Table of Contents:

The health care job that's most in demand in each state, based on data MSN; by Paxtvn Merten; 11/17/24 ... The job? Home health and personal care aides. The U.S. expects to add close to a million jobs in this profession over the next decade. ... After COVID-19 devastated nursing homes, surveys have found fewer Americans are willing to live in them as they age. As a result, even more families may discover ways to use full-time or part-time in-home aides for end-of-life care. An analysis including more than 70 other health care jobs projected all but three states to add home health and personal care aides in the highest numbers. In just three states—Colorado, Florida, and South Dakota—did registered nurse job growth outpace home health. ... Medical Technology Schools identified the health care positions expected to add the most jobs in each state and Washington D.C. from 2020 to 2030, using Bureau of Labor Statistics data compiled by Projections Central. States are listed in alphabetical order, and the top three health care positions by the number of new jobs are provided. ...Editor's note: Click here for the US Department of Labor's "Projections Central" for state-specific data and projections.

Carolina Caring celebrates fourth graduating class of CNA Training and Job Placement Program Focus, Newton, NC; 11/13/24 On the evening of Thursday, October 24th, Carolina Caring recognized the seven graduates of its latest Certified Nurse Aide (CNA) Training and Job Placement Program. ... This state-approved CNA Training Program runs for eight weeks at Carolina Caring’s Newton campus on 3975 Robinson Road. Led by licensed nursing instructors, these courses provide expert hands-on education which prepares students to pass the intensive North Carolina Nurse Aide certification exam. Students receive financial aid throughout the program, and all graduates who successfully complete their certifications are offered positions with Carolina Caring. ... “Carolina Caring blessed me by selecting me for this program and providing me with an opportunity that I otherwise would not have been able to financially invest in at this current moment,” said Allison Ackley, class valedictorian. “They poured into me, and so I’m going to be pouring back into them.”Editor's note from Carolina Caring's website: "In 1979, Carolina Caring was established as one of North Carolina’s original three hospice providers. We were a small group of grassroots volunteers with a mission: to help our parents, grandparents and neighbors walk through their final moments with dignity and respect." We congratulate you on this innovative, mission-driven educational and staffing initiative.

Sioux City’s first Caregiver Olympics celebrates home care KCAU Sioux City; by Alyssa Tatsch; 11/7/24 November is National Care at Home Month, and to celebrate, several local healthcare organizations came together to participate in Sioux City’s first Caregiver Olympics. “I was watching the Olympics this summer and I was thinking of something fun to do with our caregiving team,” Visiting Angels owner and director Kristen Hammerstrom said. “Then I was at a meeting with some of the other [home care organizations] and I floated the idea to them and they said ‘that would be awesome.’” In honor of National Hospice and Palliative Care month, nine Sioux City caregiving teams went head-to-head competing in a relay race with specialized in-home care tasks. ... “As much as it is difficult to be a caregiver, it is also difficult for these employees too to help and take care of families, so this is just our light heartfelt fun moment to help people,” Hospice of Siouxland marketing & fund director Kim Wilson said. Despite the friendly competitive atmosphere, all nine teams shared one common goal. “While we might be competitors, at the end of the day our main goal is to care for patients and make sure that our patients and their loved ones are taken care of. That is our main goal,” Wilson said.

Polk County home health aide accused of sleeping on the job arrested in man’s death: ‘He was old anyway' Fox 13, Winter Haven, FL; by Fox 13 News Staff; 9/30/24 A home health aide in Polk County is being held without bond after investigators say she fell asleep, and an 86-year-old man died in her care. ... The Polk County Sheriff’s Office says the victim’s family hired around the clock care from Assisting Hands, which consisted of two 12-hour shifts during the day and night. The victim had recently been hospitalized and was diagnosed with congestive heart failure. He was also receiving services from Good Shepherd Hospice. ... After the day shift nurse left, investigators say Taylor fell asleep on the couch in the living room, which is against company policy that states she should not have been sleeping. Deputies say Taylor woke up around 1 a.m. on August 16 and heard a thump coming from the victim’s bedroom. According to PCSO, Taylor went into the bedroom and saw the victim lying on his right side, on the floor, with his head wedged in between the nightstand and the bed. She told detectives that she tried to help him back into bed but that he told her not to touch him, so she left him on the floor and did not call anyone, including 911 or her employer, which is against company policy. ... According to the Medical Examiner, had Taylor called 911 when she first found the victim, as required by her own company’s policy, the victim would not have died. The Medical Examiner ruled the victim’s cause of death positional asphyxia with a contributory cause of pre-existing health issues.

The evolving landscape of Amyotrophic Lateral Sclerosis: A fatal disease!  Delveinsight; 9/24/24 Amyotrophic Lateral Sclerosis (ALS) is a devastating neurodegenerative disease characterized by the progressive degeneration of motor neurons, leading to muscle weakness, paralysis, and ultimately, death. ... Despite ALS being relatively rare, affecting 2-5 per 100,000 people worldwide, the question Is ALS on the rise? is gaining attention. While global prevalence has not significantly increased, improved diagnostic techniques, earlier detection, and greater awareness have led to a more accurate identification of ALS cases. Many researchers believe that enhanced surveillance and better tools for genetic testing are uncovering more cases than previously recognized, rather than a true rise in the disease’s incidence. However, with an aging global population, the burden of ALS may grow, as age is a major risk factor. Editor's note: Do you provide disease-specific training for your staff? ALS patients' and families' needs are unique. A significant disease comparison is between ALZ (Alzheimer's) and ALS. With ALZ (Alzheimer's), the brain decreases its abilities to function while the body can remain strong; the person is mobile with cognitive limitations. In contrast, with ALS, the body decreases its abilities to function while the brain/mind/emotions can remain strong. The person is immobile with cognitive awareness, but extreme physical limitations in communicating one's thoughts, emotions, and needs. ALS-specific communication tools provide crucial help for all. For more information in your location, visit The ALS Association's USA map.

Amid trauma and burnout, it ‘takes courage’ to reflect on mental, emotional well-being Healio; by Jennifer Byrne; 7/31/24 ... [William E. Rosa, PhD, MBE, MS] began to realize that in the stressful, devastating situations he and his colleagues faced daily, there was much to be learned from the principles of trauma-informed care. ... “This is the idea that cultivating an awareness can prevent us from re-traumatizing ourselves and others,” he said. “I think it starts with reflecting on — and telling the truth about — our mental and emotional well-being. That takes courage.” In acknowledging the emotional scars, brokenness and vulnerability that comes from tragedy and loss, individuals can begin to heal a lifetime of stored and unresolved trauma, Rosa said. “As a workforce, you and I see unacceptable rates of suicide, burnout, moral distress and attrition,” he said. “It’s time that we come to safe and supported terms with our trauma — not just as individuals, but as a collective, not only for the patients and families we serve, but for us to survive.”Editor's Note: In this article, Dr. Rosa identified "the emotional impact of taking yet another patient off the ventilator at the end of life." Recent articles we've posted in this newsletter about trauma-informed care been in our "Top Reads." While those articles focused on trauma-informed care of the persons you serve, this focuses on the persons who serve, your all-important direct patient care clinicians.

Proactive fall prevention: Elevating patient safety and healthcare excellenceHealthCare Business News; by Amy Hester; 7/26/24... The significance of fall prevention cannot be overstated, as it directly impacts patient outcomes and overall healthcare quality. With the patient safety solutions market growing at an expected rate of 11.2%, the importance of proactive fall prevention strategies becomes even more evident. ... In the United States, preventable medical errors, including falls, are the third leading cause of death. The impact of falls on patient health and recovery is profound, often leading to longer hospital stays, delayed recovery and increased risk of subsequent falls.Editor's Note: Proactive fall prevention is especially important for persons needing palliative or hospice care. As the person's health and mobility declines, they have to adjust to these changes mentally, emotionally, physically, and relationally. Recognizing decline can feel like defeat. Asking for help can be tough. Family members can expect the person to move more independently more than possible, leading to falls.