Literature Review

Racial/ethnic differences in care intensity at the end of life for patients with lung cancer The ASCO Post, by Matthew Stenger; 3/21/24 The study used data from the California Cancer Registry linked to patient discharge data abstracts. The primary outcome measure was intensity of care in the last 14 days before death, with greater intensity defined as any hospital admission or emergency department visit, intensive care unit (ICU) admission, intubation, cardiopulmonary resuscitation (CPR), hemodialysis, and death in an acute care setting. ... The authors concluded: “Compared with [non-Hispanic White] patients, [Asian/Pacific Islander], Black, and Hispanic patients who died with lung cancer experienced higher intensity of [end-of-life] care. Future studies should develop approaches to eliminate such racial and ethnic disparities in care delivery at the [end of life].”

8 likely next in-demand nursing roles, per Tampa General's chief nurse Becker's Clinical Leadership, by Laura Dyrda; 3/15/24 ... "In the next two to three years, the nursing team may require new roles and skills to adapt to the changing healthcare landscape," said Wendi Goodson-Celerin, DNP, APRN, senior vice president and chief nursing executive at Tampa (Fla.) General Hospital. Dr. Goodson-Celerin outlined potential roles and skills that may be in demand over the next two to three years:

Inside Jefferson's push to engage retired nurses Becker's Clinical Leadership, by Mariah Taylor; 3/21/24 Philadelphia-based Jefferson Health is keeping more retired nurses connected to the system through its Nurse Emeritus program. ... The program offers retirees an opportunity to reenter the workforce and provide guidance to new nurses and help nurses at the bedside. To participate, retired nurses must have an active New Jersey nursing license, work at least eight hours per month and have retired in the last three years. Nurse Emeritus participants work in an education-based role and do not perform hands-on clinical care or medication administration. 

Amid tense negotiations, Oregon nurses allege patient neglect by PeaceHealth during strike Eugene Register-Guard, by Miranda Cyr; 3/20/24 Tensions between PeaceHealth and Sacred Heart home health and hospice nurses persist, with the Oregon Nurses Association (ONA) claiming last week that PeaceHealth neglected patients during the nurses' two-week strike in February. ... ONA has been negotiating a new contract with PeaceHealth for a full year. The last contract expired in April of 2023. Despite 40 negotiation meetings, no agreement has been reached, according to ONA.

Bill to help health workers with burnout moves ahead in Congress Modern Healthcare, by Michael Mcauliff; 3/20/24 A bill designed to help counter depression, burnout and suicide among healthcare providers cleared a key hurdle Wednesday, passing unanimously out of the House Energy and Commerce Committee. The Dr. Lorna Breen Health Care Provider Protection Reauthorization Act of 2024 updates and extends for five years an earlier version of the law. It funds grants for healthcare organizations and associations to run programs aimed at improving workers' mental health amid staff shortages and ongoing fallout from the COVID-19 pandemic. 

Frailty needs to be a factor in drug development, proposed guidelines suggest McKnights Long-Term Care News, by Kristen Fischer; 3/20/24A new report on strategies for geriatric drug development and assessment determined that drugs need to consider age as well as other factors that older adults face such as cognitive impairment, frailty and polypharmacy. This is according to the International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee, which published the report. The strategies specifically focused on integrating frailty as a factor in drug development. The report, published in the Journal of the American Geriatrics Society earlier this month, includes 12 principles pertaining to frailty in reference to drug development. The recommendations include measuring frailty at the start of when a person goes on a drug they’ll likely take regularly.

Nurses practicing primarily in care homes ‘improve end-of-life care’ Nursing Times, by Steve Ford; 3/19/24 Nurses and other clinicians who specialise in working in care homes represent an important resource when it comes to improving the quality of end-of-life care for residents, a large US study suggests. Researchers found nurse practitioners working mostly in care homes may decrease the likelihood of residents experiencing stressful hospital admissions and improve the quality of life in their last days. 

Health care utilization and opioid use in patients receiving an integrated palliative care intervention for treatment of head and neck cancer compared to a historical control Elsevier, International Journal of Radiation; by F. Rizwan. C. D'Avella, M. Albert, T. King, B. Egleston, T.J. Galloway, M. Chwistek, C. Fang, A. El-jawahri, J.R. Bauman; online access for 4/1/24 release Patients receiving chemoradiation therapy (CRT) for head and neck cancer (HNC) can develop significant symptomology (odynophagia, malnutrition) resulting in frequent hospitalizations and decreased quality of life (QOL) and continue to have chronic symptoms such as dysphagia and/or pain. The integration of a palliative care (PC) team during CRT has the potential to address the high symptom burden and improve QOL.

Creating a community-led telehealth approach for supportive cancer care mHealthIntelligence, by Anuja Vaidya; 3/18/24 Tennessee Oncology is joining forces with rural patients to explore strategies for expanding telehealth access to supportive cancer care services. ... The NEST program aims to expand access to palliative care, psychology, and integrative oncology and nutrition services among rural cancer patients in seven Middle Tennessee counties: Robertson, Dickson, Putnam, Dekalb, Warren, Bedford, and Coffee counties.

Improvements in Interdisciplinary Communication Following the implementation of a standardized Handoff Curriculum: SAFETIPS (Statistics, Assessment, Focused Plan, Pertinent Exam findings, to Dos, If/Thens, Pointers/Pitfalls, and Severity of Illness) Cureus, by Shaefali Shandilya and Justen M. Aprile; 3/18/24 Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process among physicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physician and nursing interactions. ...Results: Statistical analysis revealed significant post-intervention mean score increases of one full point in four categories, namely organization and efficiency, communication, content, and clinical judgment.

Navigating difficult conversations with patients with terminal cancer diagnoses Oncology Nursing News, by Darlene Dobkowski, MA; 3/18/24 Although oncology nurses need strong communication skills to help all of their patients navigate their cancer journeys, it is critical to have the ability to have difficult conversations with patients who received a terminal diagnosis, ... Betty Ferrell, Ph.D., M.S.N., CHPN, director and professor in the Division of Nursing Research and Education in the Department of Population Sciences at City of Hope in Duarte, California, said in an interview with Oncology Nursing News. For the past 24 years, her institution has been directing a project called the End-of-Life Nursing Education Consortium (ELNEC), which is a palliative care training program and includes a module focused on communication.  ... “One of the things that we teach nurses is … that your No. 1 job is to listen,” Ferrell said. “Another thing that we say to nurses is, it is not your job to have all the answers. Patients ask very unanswerable questions. ‘Why me?’ is not an answerable question. But when a patient says, ‘Why me,’ then we want nurses to have good communication skills to say, ‘I can imagine why you're asking that question. Because as you've shared with me, you had no idea that you might be diagnosed with cancer, or you're the first person in your family to ever have cancer.’”

Hines VA introduces new monitoring system for hospice and nursing home Veterans VA Press Release; 3/15/24 Edward Hines Jr. VA Hospital has begun integrating a new patient monitoring system to improve Veteran health and assist medical staff. The AvaSure© Continuous Video Monitoring System places portable cameras in patients’ rooms who may need closer monitoring. Staff can observe up to 15 patients simultaneously through a virtual interface to monitor for issues such as a patient out of bed or patient-caused medical device interference. ... The monitoring system will be used in Hines VA’s Community Living Center (CLC), which includes short- and long-term nursing home care and hospice. 

Breast cancer palliative care and metastatic disease: Looking beyond end of life MedPage Today, by Shalmali Pal; 3/15/24 ... It is important to inform patients that they can receive palliative care at any timeopens in a new tab or window during their treatment, from the time of diagnosis to end of life. ... At some juncture, the options for metastatic breast cancer treatment become limited. Progression can be classified into four general types: