Literature Review

RNs are moving away from home health and hospice, federal survey reveals McKnights Home Care, by Adam Healy; 4/2/24 Though the number of registered nurses continues to grow, fewer are working in home healthcare and hospice compared to years past, according to the latest national sample survey collected by the Health Resources & Services Administration. In 2018, there were 179,509 RNs working in home health and hospice, representing about 6% of the nursing workforce, according to an earlier national survey. HRSA’s latest count estimated that there were 173,808 RNs in home health and hospice in 2022, or only 5% of the workforce. 

Palliative care could be a game changer for public health Harvard Public Health, by Meredith Lidard Kleeman; 4/4/24California and Hawaii are pioneering ways to expand access. ... California is one of the first states in the country to require insurance companies that administer Medicaid benefits to fully cover palliative care services for eligible residents. ... Palliative care is poised to be a game changer for public health. Nearly 50 percent of states now include palliative care services for eligible Medicaid recipients, according to C-TAC. And in California and Hawaii, two paths are being forged toward wider palliative care access. ... 

Blue Shield's Palliative Care Program wins national recognition for improving lives Blue Shield California; 3/28/24 During the first quarter of this year, the Journal of Palliative Medicine published results of a study entitled “Cost and Utilization Implications of a Health Plan’s Home-Based Palliative Care Program” from leaders at Blue Shield and researchers from West Health Research Institute that garnered attention from industry publications. ...  Major findings from the study were that home-based palliative care delivered to people not yet eligible for hospice reduced their hospital and emergency room use, showed trends towards an increased length of life, and extended the continuum of care for people with serious illness and their caregivers.

[Maine] Senate backs safe staffing bill with aim to increase patient safety, decrease nurse burnout Main Morning Star, by Lauren McCauley; 3/27/24 If passed, Maine would be the second state in the country to institute nurse-to-patient ratios. ... Sen. Stacy Brenner (D-Cumberland), who sponsored the bill, shared with the chamber her experience as a nurse and how the stress of being understaffed can contribute to burnout and what she described as “moral distress.” ... Brenner said the bill accomplishes two goals: increasing patient safety and increasing nurse retention. 

Northwell hospital nurses cancel strike Becker's Hospital Review, by Kelly Gooch; 4/1/24Members of the New York State Nurses Association have called off a planned April 2 strike at New York City-based Staten Island University Hospital after reaching a tentative agreement with management on a new labor contract. The union represents 1,300 workers at the facility. ... SIUH is part of New Hyde Park, NY-based Northwell Health, a 21-hospital system with more than 85,000 employees total. ... The agreement "adds nurse staffing on units that need help"; includes an expedited process for creating staffing standards in new units; and features wage increases that total 22.12% over three years and include annual pay increases, market adjustment pay, and experience pay, the union said.

Palliative and hospice care in hospitals and clinics: the good, the bad, and the ugly MedPageToday's KevinMD.com; by Earl Stewart, Jr., MD and Miguel Villagra, MD; 4/1/24 I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you can.” ...

Cancer patients often want ‘one more round.’ Should doctors say no? The Washington Post, by Mikkael A. Sekeres, MD; 3/31/24 My patient was in his early 30s and his leukemia had returned again following yet another round of treatment. He was a poster child for the recently reported rise in cancer rates in the young, and had just asked me what chemotherapy cocktail I could devise for him next, to try to rid him of his cancer. I hesitated before answering. Oncologists are notorious for always being willing to recommend to our patients one more course of treatment, even when the chances of success are negligible.  

UT Tyler School of Medicine receives $400k gift from anonymous donor [for hospice and palliative medicine fellowship] The Gilmer Mirror; 4/1/24The University of Texas at Tyler School of Medicine received a  $400,000 gift from an anonymous donor to support the hospice and palliative medicine  fellowship. The purpose of the gift is to retain physicians in the East Texas region. 

Integrating palliative care screening in the intensive care unit: A quality improvement projectCritical Care Nurse; by Traci N. Phillips, DNP, APRN, ACNP-BC, CCRN; Denise K. Gormley, PhD, RN; Sherry Donaworth, DNP, APRN, ACNP-BC, FNP-BC; 4/1/24Background: Patients admitted to the intensive care unit have complex medical problems and increased rates of mortality and recurrent hospitalization for the following 10 years ...  Delayed access to palliative care can result in untreated symptoms, lack of understanding of care preferences, and preventable admissions. Conclusion: The screening process can maximize the benefit of palliative care services with early patient identification, improved consultation efficiency, decreased critical care resource use, and reduced readmission rates.

Pediatric Division - National Coalition for Hospice and Palliative Care National Coalition for Hospice and Palliative Care; 3/28/24The National Coalition for Hospice and Palliative Care’s Pediatric Division represents a multi-disciplinary, volunteer team of pediatric palliative care (PPC) leaders. The Division membership is comprised of representatives from all 14 members of the Coalition, three family advocates, as well as representatives from aligned stakeholder organizations including the American Academy of Pediatrics, American Psychological Association, Association for Child Life Professionals, and the State Coalition Network. 

Why a Texas system hasn't hired a travel nurse in 30 years Becker's Hospital Review, by Kelly Gooch; 3/28/24 Beth Schmidt remembers the last time Fort Worth, Texas-based Cook Children's Health Care System hired a travel nurse, and it was not recently. ... Many hospitals and health systems increased their reliance on travel nurses during the pandemic to fill vacancies. However, a number of organizations are now making efforts to decrease their dependence for financial reasons. ... [This organization has had 15-20 years success with] the Winter Plan, a program ... [that] allows workers to temporarily become Cook Children's employees for four to six months to help augment the health system's nursing staff. 

14 Joint Commission patient safety goals for post-acute facilities Becker's Hospital Review, by Mariah Taylor; 3/21/24 The Joint Commission released a breakdown of patient safety goals for post-acute care facilities in 2024. The organization published an easy-to-read resource outlining goals for nine sectors of healthcare, including nursing facilities, surgery, hospitals and behavioral care. For post-acute facilities, the goals mostly revolved around identifying patients correctly, using medicines safely, and preventing infections and falls. Here are the patient safety goals for post-acute facilities: ...

From doctor to family: Witnessing both sides of end-of-life care MedPage Today's KevinMD.com, by Jessica Bloom, MD; 3/27/24We all have those moments in medicine when we know that care has become more futile. Then we do everything in our power to educate, support, gently guide, and give permission to patients and families. There are moments that treating for a cure goes against our tenet to “first do no harm.” ... Specialists and his regular physicians sat with us, listened to my family’s questions, and offered kindness along with medical advice. They gently helped my siblings let go of futile searching for treatments. ...