Literature Review

20 states facing acute nursing shortages Becker's Hospital Review, by Kelly Gooch; 3/25/24 ... On March 1, Medical Solutions, a healthcare staffing company, released the 20 states where nurses are needed the most based on the most current nurse-to-state population ratios and projected need by 2030. Ratios in the report were from Census and Bureau of Labor Statistics data published in NurseJournal. Projected need by 2030 is from Projections Central, a site sponsored by the Labor Department. Here are the 20 states where nurses are needed the most, per the Medical Solutions article: ... 

Fall prevention for the elderly: 13 strategies to keep them safe U.S. News & World Report, by Claire Wolters, ed. by Christine Comizion, MPH; 3/26/24Falls are the leading cause of injury in adults 65 and older – with reports showing about 14 million adults fall each year, according to the Centers for Disease Control and Prevention. ... According to the CDC, falls are also the leading cause of injury-related death in the 65-and-older population – and the fall death rate is growing.Here's what to know about what increases risk for falls in older adults, and get familiar with fall prevention tips and safety measures that can help reduce the risk.Editor's Note: This U.S. News article primes the pump. Preventing falls matters especially for vulnerable hospice patients as their disease progresses, and as they and/or family want the person to be as mobile as possible. What do your Incident Reports tell you about falls? What falls-specific education do you provide for your interdisciplinary teams? On-call staff? Family caregivers? Volunteers? What QAPI programs have addressed falls? 

Antibiotics in end-of-life care NEJM Journal Watch, by Abigail Zuger, MD; 3/27/24Antibiotics often are considered to be among the gentler and more comfort-oriented interventions in end-of-life care, certainly far less aggressive than intubation or last-ditch surgery. ... Still, antibiotics do entail their own costs in the form of toxicities and need for intravenous access, and liberal antibiotic use reliably worsens institutional and community drug-resistance profiles. ... A new review was written for infectious disease consultants but contains specific suggestions that should interest both generalists and other subspecialists caring for dying patients. 

New Orleans nurses rally before union contract negotiations Healthcare Journal of New Orleans; 3/26/24Nurses rallied on March 25 at University Medical Center (UMC) in New Orleans as they began negotiations on their first union contract with LCMC Health, the hospital’s management. Nurses at UMC made history in December when they overwhelmingly voted to join National Nurses Organizing Committee/National Nurses United (NNOC/NNU), becoming the first unionized private-sector hospital in the state of Louisiana and members of the largest nurse’s union in the United States. 

Tele-palliative care benefits veterans with cardiac, pulmonary diseases Hospice News, by Jim Parker; 3/26/24 Patients with cardiac and pulmonary conditions see improvements in their quality of life after receiving palliative care via telehealth. A randomized clinical trial with 306 participants who suffered from chronic obstructive pulmonary disease (COPD), heart failure (HF), and interstitial lung disease (ILD) found that palliative telehealth resulted in significant improvements. The results were published in the Journal of the American Medical Association.

Meaningful conversations to have with your loved oneMediaFeed.org, by Merritt Whitley; 3/27/24“One of the most important concepts in the field of grief and loss is that people drift in and out of the awareness of dying,” says Kenneth Doka, a senior consultant to the Hospice Foundation of America, and professor emeritus of gerontology at the graduate school of The College of New Rochelle. “Sometimes they do talk about it, sometimes not. The dying one should control the agenda. Don’t force conversations on them.” When your loved one feels ready to talk, the following suggestions can be comforting ways to begin a conversation: ...

Palliative care in the cardiovascular intensive care unit: A systematic review of current literatureCardiovascular Revascularization Medicine, by Agastya D Belur, Aryan Mehta, Mridul Bansal, Patrick M Wieruszewski, Rachna Kataria, Marwan Saad, Annaliese Clancy, Daniel J Levine, Neel R Sodha, Douglas M Burtt, Gregory S Rachu, J Dawn Abbott, Saraschandra Vallabhajosyula; 3/24/24, online ahead of print Results: Of 5711 citations, 30 studies were included. All studies were published in the last seven years and 90 % originated in the United States. Heart failure was the most frequent diagnosis (47 %), and in-hospital mortality was reported in 67 % of studies. There was heterogeneity in the timing, frequency, and background of the care team that determined palliative care consultation. In two randomized trials, there appeared to be improvement in quality of life without an impact on mortality.

How home-based care providers are leveraging palliative care in hospital partnerships Home Health Care News, by Patrick Filbin; 3/26/24 Oftentimes, talks between home health providers and their many referral partners are an exercise in education. For providers offering palliative care, that education usually starts at a 101-level. Part of that conversation with hospital and health system partners includes convincing case managers that patients will be better suited at home. Editor's Note: Features Choice Health at Home CEO David Jackson; Kaiser Permanente Senior Director of Care Hospice and Palliative Care Gina Andres

Hospice of Santa Barbara offers insights into family grievingSanta Barbara Independent, by Hospice of Santa Barbara; 3/26/24Grieving the loss of a family member is a deeply intricate emotional journey. Shared bonds and histories make family grief especially unique. Family grief extends beyond the individual and intertwines with the collective fabric of shared experiences, roles and responsibilities. ... It is common for death to change the family dynamic. This can be a result of several factors, including age, relationship, role, difference in coping mechanisms, heightened stress and emotions, and unresolved family issues which can lead to the resurfacing of past grievances.Editor's Note: CMS Hospice COPs §418.3 defines: "Bereavement counseling means emotional, psychosocial, and spiritual support and services provided before and after the death of the patient to assist with issues related to grief, loss, and adjustment." The interdisciplinary team needs to understand individual and family grief, within the scope of their roles and responsibilities with family members.

Northwell hospital nurses set strike date Becker's Hospital Review, by Kelly Gooch; 3/22/24 Members of the New York State Nurses Association are set to strike April 2 at Staten Island University Hospital in New York City. The union represents 1,300 workers at the facility, according to an NYSNA news release. ... The union cited concerns about having enough staffing to meet the needs of the Staten Island community and contends wages are also still a key sticking point at the bargaining table. Members are seeking a contract that ensures enough experienced nurses are at the bedside to provide safe patient care.

Caring for patients with non-English language preferences American Association of Critical-Care Nurses; 3/25/24 ... With a growing population of people who speak a language other than English at home, nurses and other healthcare professionals must work toward providing better language-inclusive medical care. ... Nurses and other clinical providers must be well-informed regarding the lifesaving nature of language access in healthcare despite any personal bias against or perceived inconvenience of using interpreter services. [This article includes: ]

Palliative care improves quality of life for bone marrow transplant patients Duke Health News & Media, by Alexis Porter; 3/25/24 ... Researchers tested the effectiveness of an integrated palliative care intervention across diverse settings. They enrolled 360 adults undergoing bone marrow transplants at three academic medical centers, including Duke University Hospital, Massachusetts General Hospital and the Fred Hutch Cancer Center at the University of Washington. ... Patients receiving the palliative care intervention reported better quality of life, defined by the degree to which an individual is healthy, comfortable, and able to participate in life events. They also had lower depression, PTSD and fatigue symptoms compared to those receiving usual care.