Literature Review

VITAS Healthcare is first hospice organization to earn American Heart Association Heart Failure Certification across all 15 states and DC Florida News Guide, Miami, FL; Press Release; 3/18/25 ... VITAS has become the first nationwide hospice provider to earn the American Heart Association® Palliative/Hospice Heart Failure certification across all 15 states in which it operates. The certification applies to 56 unique VITAS service areas, including the District of Columbia. ... “Many patients with heart failure do not receive the hospice care that could significantly improve their final months of life,” said Joseph Shega, MD, executive vice president and chief medical officer at VITAS. “This certification affirms our commitment to providing evidence-based hospice care that helps patients and families navigate advanced heart disease with dignity, comfort and the right level of support.”

End-of-life conversations: ‘When they open the door, you have to go in’ Oncology Nursing News; by Pattie Jakel, MN, RN, AOCN; 3/13/25Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” And I said, “It’s not going to be today, but I think it’s going to be soon.” And she kind of chuckled, because her sister was at the bedside, and she said to her sister, “I need my makeup done. I want my makeup on today, if today’s not the day.” And that took us to a whole conversation about what dying would look like for her.Editor's note: Read and share this significant, sensitive video/article from its source, Oncology Nursing News. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

[International] Healthcare on the brink: Palliative Care Unit and Late Shift The 75th Berlin International Film Festival - Part 7, wsws.org; by Martin Nowak and Bernd Reinhardt; 3/16/25 Two films, the drama Late Shift (Heldin) and the documentary Palliative Care Unit (Palliativstation), featured at this year's Berlin International Film Festival, addressed the current situation in German and Swiss hospitals. The sold-out festival screenings reflected the burning public interest in this topic. This is particularly remarkable bearing in mind that Palliative Care Unit has a running time of more than four hours. ... [In the] documentary Palliative Care Unit by Philipp Döring, shot at the Franziskus Hospital in Berlin, ... [the] camera quietly observes the daily routine, staff consultations and the constant empathy of the head of the ward towards employees and seriously ill patients, who usually spend their last weeks here. The very calm, always discreet images emphasise the necessity of sufficient time for care and reflection when making life-critical decisions. ... How can the highest possible quality of life be achieved? The high ethical standard of treating incurable patients as active human beings ... is admirable and makes a lasting impression throughout the film.

Sarcopenia in terminally ill patients with cancer: Clinical implications, diagnostic challenges, and management strategies Journal of Hospice & Palliative Care; by Se-Il Go, Myoung Hee Kang, and Hoon-Gu Kim; 3/1/25 Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, is a prevalent but often overlooked condition in patients with cancer who are terminally ill. It contributes to functional decline, increased symptom burden, and reduced quality of life, yet remains underrecognized in palliative care. Diagnosing sarcopenia in this population is challenging because conventional imaging techniques are often impractical. Instead, alternative assessments, such as the Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire (SARC-F), anthropometric measurements, and bioelectrical impedance analysis offer feasible options. Management should focus on symptom relief, functional preservation, and patient comfort, rather than on muscle mass restoration.

Malpractice lawsuits are rising — here’s how physicians can protect themselves Becker's ASC Review; by Patsy Newitt; 3/11/25 Medical malpractice insurance is essential for protecting physicians from financial and legal risks, particularly amid the rise in malpractice lawsuits, according to a March 5 article on Physicians Thrive’s website.  In 2023, malpractice verdicts hit a record high. There were 57 medical malpractice verdicts of $10 million or more, with more than half of those verdicts hitting $25 million.  Here are nine things to know from the Physician’s Thrive article. 

Q&A: Nursing and the integration of technology at HIMSS25 mobihealthnews; by Anthony Vecchione; 3/10/25 Lavonia Thomas, nursing informatics officer at the University of Texas MD Anderson Cancer Center, sat down with MobiHealthNews at the HIMSS Global Health Conference & Exhibition in Las Vegas last week to discuss how nurses are implementing digital tools that help improve patient care.  ... [Thomas:] "We are having some great success in nurses' engagement and their feeling of being highly engaged. A nurse is not going to tell you, "I love the electronic health record" or certain things about technology. What is important is that they feel that they are heard, that their feedback is taken into the design and development and that their workflows are assessed." ...

Intervention increases palliative cancer care consultations/lowers EOL care CancerNetwork.com; by Roman Fabbricatore; 3/11/25A palliative care (PC) intervention combining algorithm-based automated identification of patients eligible for PC led to an increase in PC visits and a decrease in end-of-life systemic therapy among patients with cancer, according to a randomized clinical study (NCT05590962) published in JAMA Network Open. ... "...  Prior efficacy trials in oncology have tested early PC in controlled, primarily academic settings.2To our knowledge, this is the first effectiveness randomized clinical trial of algorithm-driven default specialty PC in community oncology.”

Assessing pain, anxiety and other symptoms of nursing home residents unable to speak for themselves Regenstrief Institute, Indianapolis, IN; by Kathleen T. Unroe, MD, MHA; 3/10/25 Revamped tool reliably addresses physical and emotional distress, well-being and end-of-life symptoms. As many as half of nursing home residents are cognitively impaired and may be unable to communicate symptoms such as pain or anxiety to the staff and clinicians caring for them. Therefore, information needed for the evaluation of symptoms and subsequent treatment decisions typically does not reliably exist in nursing home electronic health records (EHRs). A new paper reports on the novel adaptation of a commonly used symptom assessment instrument to more comprehensively acquire this difficult-to-obtain data with the ultimate goal of enabling knowledge-based expansion of palliative care services in nursing homes to address residents’ symptoms. 

Tumor: why not use the warrior’s metaphor anymore taketonews; 3/7/25 ... The term "warrior" is often used to describe cancer sick people, referring to their strength, determination and ability to fight the disease. Although the intention is positive, docts and psychologists believe that this metaphor can generate negative effects on people with an oncological disease. The "warrior" label is not always appropriate and can have unwanted psychological effect on cancer patients. ... Use a language that does not reduce the patient to his struggle, but that enhances his entirety, including weakness, depression and pain, can contribute to a more human and respectful experience of care. ... [Click on the title's link for this further information below.]

Report finds those with Parkinson’s have unmet hospice needsMcKnights Long-Term Care News; by Kristen Fischer; 3/6/25 Hospice use varies depending on whether a person has Parkinson’s disease, Lewy body dementia or Alzheimer’s disease and those with Parkinson’s may have more unmet needs, a new study finds. Researchers evaluated data on 11,327,324 Medicare beneficiaries enrolled in hospice between 2010 and 2020 as part of their study, which was published Tuesday in JAMA Network Open. ... Hospice enrollees who had Parkinson’s disease and dementia with Lewy bodies were less likely to be disenrolled from hospice due to extended prognosis compared to those with Alzheimer’s disease. People who had Parkinson’s disease but not dementia with Lewy bodies were more apt to have longer stays over 180 days and turn hospice away compared to those with Alzheimer’s disease. (Short stays were defined as those less than seven days.)

Concerning new data on female physician suicide Medscape Medical News; by Pauline Anderson; 2/28/25 Suicide rates for female physicians in the United States between 2017-2021 were 47% higher than for women in the general population, results of a retrospective cohort study showed. Unlike their female counterparts, male physicians had a lower rate for suicide relative to the general male population, investigators found. “The results indicate we need added multimodal and comprehensive suicide prevention specific for physicians,” lead study author Hirsh Makhija, MS, postgraduate researcher, Department of Psychiatry, University of California San Diego School of Medicine, told Medscape Medical News. ... The findings were published online on February 26 in JAMA Psychiatry. 

Nurse leaders can take the lead in promoting civility in the workplace Oncology Nurse Advisor; by Susan Rux, PhD, DNP, RN, FACHE; 2/28/25 Civility, the act of respecting others, especially in situations where disagreement or disparity may arise, occurs by intentionally displaying kindness and empathy. These behaviors help people to understand differences as well as uphold common ground across all social contexts. A stable foundation, afforded through civil actions, serves as a catalyst in achieving environments that promote diversity, equity, and inclusivity — the underpinnings of a culture of belonging. Nurse leaders can play a key role in creating this culture. Contrary to civility, in the healthcare setting, acts of incivility lead to increased levels of staff disengagement and turnover. Researchers have noted that a civil nursing workplace provides a safeguard against numerous professional issues, including but not limited to increased turnover rates, burnout, job dissatisfaction, and stress.

Qualitative analysis through the lens of minority nurses American Nurse; by Sonya Moore, PhD, RN, CRNA; Carolyn Still, PhD, RN; and Siobhan Aaron, PhD, RN; 3/4/25 Many argue that experiences of discrimination, racism, and microaggression (intentional or unintentional) serve as key barriers to the recruitment and retention of diverse nurses. Iheduru-Anderson, who interviewed 30 Black nurses, noted that despite an increase in the number of Black nurses in the U.S. workforce over time, they remain significantly underrepresented in leadership and faculty positions. The study identified several themes that contribute to lack of advancement, including maintaining White comfort, distrust, lack of role models and representation, expectations about leadership roles, and the ineffectiveness of advanced degrees in securing advancement.