Literature Review

Hospices stepping up performance on visits-in-last-days-of-life measure Hospice News, by Jim Parker; 3/14/24 Hospices, in aggregate, are showing improvement on the quality measure for visits in the last days of life. The number of registered nurse and social worker visits during a patient’s final week is one of the seven quality measures that CMS uses to evaluate providers. In Calendar Year 2021, the share of hospice care days with nurse visits in the last seven days of life rose to 63%, up from 62% year over year, according to the National Hospice and Palliative Care Organization (NHPCO). 

Responding to Soul Injury: Tools for hope and healing Journal of Hospice & Palliative Nursing; by Deborah Grassman, Abi Katz, Luann Conforti-Brown, Josephine F Wilson, Angie Snyder; 3/13/24Soul Injury is defined as a wound that separates a person from their real self, caused by unmourned loss and hurt, unforgiven guilt and shame, and fear of helplessness or loss of control. Tools and interventions have been developed to guide people impacted by Soul Injury. This study assessed the effectiveness of 12 tools and interventions, ... The Anchor Your Heart tool was the most frequently used tool and had the most enduring utilization across time and settings.Editor's Note: Click here for The Anchor Your Heart Tool identified in this article. Share this research and article with your clinical teams and bereavement counselors.

Palliative and end-of-life care in hematologic malignancies: Progress and opportunities JCO Oncology Practice, by Mazie Tsang, MD, MAS, MS and Thomas W. LeBlanc, MD, MA, MHS, FAAHPM, FASC; 3/13/24 ... An important finding from this study was the qualitative data from narratives of volunteer caregivers and hospice staff that described daily patient care, changes in patient status, perceived symptom burden, and indications for medication administration. The authors identified skin integrity concerns, bleeding, pathologic fractures, and delirium as unique issues for patients with hematologic malignancies enrolled on hospice. ... These findings provide further evidence that hospice care can and does work well for some patients with hematologic malignancies. 

In the resuscitation discussion, do words matter between doctors and patients? Rutgers, by Patti Zielinski; 3/12/24Rutgers Health researchers seek to reduce barriers to physicians having code status conversations with older adults. ... The study, published in the Journal of the American Geriatrics Society, sought to determine the best language doctors could use when discussing a patient’s code status to reduce the barrier to having these conversations. It found that it takes less than five minutes on average for doctors to have discussions going over what CPR is, what a patient’s preference might be and making a decision that patients felt comfortable with regarding whether they want to be resuscitated, according to the study.Editor's Note: Click on the title above for the summary description; click here for the detailed research article, "Aligning patient values and code status: Choice of Diction's Effect (CODE) study.

Can we make more accurate prognoses during last days of life?Journal of Palliative Medicine; by Sylvie Bouchard, Andreea Paula Iancu, Elena Neamt, François Collette, Sylvie Dufresne, Patricia Maureen Guercin, Suganthiny Jeyaganth, Desanka Kovacina, Taliá Malagón, Laurie Musgrave, Marilisa Romano, Jenny Wong, Sybil Skinner-Robertson; 3/8/24Background: ... Established methods (Palliative Performance Scale [PPS], Palliative Prognostic Index [PPI]) have been validated for intermediate- to long-term prognoses, but last-weeks-of-life prognosis has not been well studied. Patients admitted to a palliative care facility often have a life expectancy of less than three weeks. Reliable last-weeks-of-life prognostic tools are needed. Conclusions: ... Using SPS [Short-Term Prognosis Signs] along with PPS and PPI during the last weeks of life could enable a more precise short-term survival prediction across various end-of-life diagnoses. The translation of this research into clinical practice could lead to a better adapted treatment, the identification of a most appropriate care setting for patients, and improved communication of prognosis with patients and families.

ACC updates HFrEF Decision Pathway, reinforcing the Four Pillars of Therapy

Is extending life by weeks worth the toll some cancer drugs take? Doctors push for 'common-sense oncology' CBC News, by Amina Zafar and Christine Birak; 3/11/24 People may celebrate a 2-week improvement in survival without acknowledging costs. When a treatment buys a few weeks or months but comes with with a lot of side-effects, then the perspectives of people with cancer may differ, says Dr. Christopher Booth. ... The goal of what they call "common-sense oncology" is to prioritize treatments that meaningfully improve survival and quality of life. They aim to address what they see as problems in the field, such as a lack of critical thinking in oncology training, falling standards for drug approvals and avoidance of end-of-life discussions.

Cooperman Barnabas Medical Center recognizes Certified Nurses DayRWJ Barnabas Health Blog; 3/11/24In honor of Certified Nurses Day, March 19, 2024, Cooperman Barnabas Medical Center (CBMC) acknowledges the 500 members of our Magnet-recognized nursing staff who have achieved and maintained national board certification during 2023 in their nursing specialty. Editor's Note: Congratulations to these certified nurses and to Cooperman Barnabas Medical Center for honoring them in such visible, meaningful way! For your organization, though time is short, what can you doto honor your certified nurses?

When health care is woven in our family fabric, we find support in unexpected places Oncology Nursing Society (ONS) Voice, by Suzanne M. Mahon, DNS, RN, AOCN®, AGN-BC, FAAN; 3/7/24... We have a built-in support system in our family. We understand all of those feelings and stressors in each other. We just get it. ... Where is your dinner table of support? Who is your go-to person who just gets it and listens? My husband and daughters support me, and I also have friends from nursing school, the workplace, and ONS who support me. They make all the difference in the world. Today, take time to thank your own support team.

NYC Health + Hospitals/Bellevue opens new Palliative Care Serenity Unit for patients and families NYC Health+Hospitals Press Release; 3/7/24 NYC Health + Hospitals/Bellevue today announced the opening of a new Palliative Care Serenity Unit for patients and families. ... “We created the Serenity Unit because we noted an increasing number of patients either spending their dying days at the hospital or in need of extra support and symptom management expertise that palliative care provides,” said Susan E. Cohen, MD, director of the Palliative Care Program at NYC Health + Hospitals/Bellevue. “We want to ensure that patients who are here in their final days are being treated with dignity and expertise.”Editor's Note: NYC Health + Hospitals/Bellevue is the oldest hospital in America, tracing their roots back to 1736 when a six-bed infirmary opened on the second floor of the New York City Almshouse.

Podcast: Outcomes post-cardiac arrest and palliative medicine consultation for seriously ill patientsThe Rounds Table Podcast, Episode 81; recorded 3/7/24 This week, Drs. Mike and John Fralick discuss two recent papers exploring patient outcomes after in-hospital cardiac arrest and the role of default Palliative Medicine consultation for seriously ill hospitalized patients. Two papers, here we go!

Programmatic palliative care consultations in pediatric heart transplant evaluations Pediatr Cardiol, by Erika J Mejia, Rui Xiao, Jennifer K Walter, Chris Feudtner, Kimberly Y Lin, Aaron G DeWitt, Meeta Prasad Kerlin; 3/8/24 Guidelines advocate for integrating palliative care into the management of heart failure (HF) and of children with life-limiting disease. The potential impact of palliative care integration into pediatric HF on patient-centered outcomes is poorly understood. The present study sought to assess the association of programmatic implementation of palliative care into the heart transplant evaluation process with hospital-free days (HFD) and end of life (EOL) treatment choices. 

Palliative care across the spectrum of heart failure JACC Heart Fail;  y Laura P Gelfman, Moritz Blum, Modele O Ogunniyi, Colleen K McIlvennan, Dio Kavalieratos , Larry A Allen; online ahead of print 2/27/24; print 3/8/24 Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. ... New models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.