Literature Review

Code status discussions; difficult but necessary The Hospitalist, by Mark Menet, MD, MPH; 4/1/24 I thought it was just where I practiced, but it turns out that, in the medical field, we’re really bad about having code discussions, which is a significant issue. When some of my patients revealed that no one had ever asked them about their code status before, I decided to conduct some research on this topic. It turns out that, at most, 41% of patients recall discussions about their code status, however, the 10.3% as documented by another study seems much more accurate.

How’s Your Soul? JAMA Network, by Daivd Vermette, MD, MBA, MHS; 3/28/24 "Brother David, how’s your soul?” The question took me by surprise. It was time for my first advisement meeting with my residency program director. In medicine, the machine runs on competence and achievement of “milestones.” Yet, as I braced for a meeting to trudge through performance evaluations and in-training exam scores, I awoke to humanity. ... Medical education has numerous models for coaching, advising, and mentoring. While these models helped develop my professional life, they missed the fundamental core of who I am: a human being. Perhaps instead we could embrace a model in medical education built on the tenets of pastoral care. ...

A multicentre survey on the perception of palliative care among health professionals working in haematology Multicenter Study / PubMed; by Sara Di Lorenzo, Lisa Mozzi, Flavia Salmaso, Claudia Silvagni, Silvia Soffientini, Vanessa Valenti, Vittorina Zagonel; 3/27/24Purpose: Patients with haematologic malignancies have less access to palliative care and are referred later than patients with solid tumours. We developed a survey to investigate this phenomenon, with the intention of analysing palliative care perceptions among health professionals who treat haematology patients and identifying barriers and facilitators to referrals to palliative care services.

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: ...

Expanding the use of continuous sedation until death and physician-assisted suicide  The Journal of Medicine & Philosophy: A Forum for Bioethics and Philosophy of Medicine; by Samuel H Lipuma and Joesph P Demarco; 3/27/24 The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. 

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? 

Bayada invests $375,000 to train future nurses in Pima County Bayada Communications, 3/26/24 Bayada Home Health Care, a nonprofit, global leader in home health care has granted $375,000 to fund nursing education for at least 15 students in Pima County. Tucson’s Bayada Skilled Nursing office ... is partnering with JobPath, a local nonprofit, to support students pursuing Licensed Practical Nurse (LPN) or Registered Nurse (RN) certifications in the greater Tucson area. The grant to JobPath ... will help cover program tuition, books, and other expenses to support those who might otherwise not be able to afford nursing education. 

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

Home care unionization efforts beginning to tick back up Home Health Care News, by Andrew Donlan; 3/25/24 The home care workforce has traditionally been a tough one to organize. But efforts have ramped up over recent years, leading to more workers opting into unions across the country. Recently, University of Rochester Medicine Home Care (URMHC) workers “overwhelmingly” chose to join a labor union. They aligned themselves with 1199SEIU United Healthcare Workers East, which is one of the largest health care worker unions in the country. 

Hospitalists more likely to recommend hospice than specialists: Study Becker's Hospital Review, by Mariah Taylor; 3/27/24 A New Haven, CT-based Yale School of Medicine study [published in the American Cancer Society Journals] suggests oncology hospitalists have better hospice utilization and reduce hospital stays for cancer patients compared to oncologists. Researchers compared referrals for hospice settings from hospitalist-led services and oncologist-led services. Hospitalist-led services referred 11.8% of patients to inpatient hospice settings, nearly double the referral rate of oncologist-led services (5.8%). The adjusted average length of stay before inpatient hospice care was 6.83 days for hospitalist-led care and 16.29 days for oncologist-led care. 

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.

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. 

A nurse practitioner-driven palliative and supportive care service in nursing homes: Evaluation of a quality improvement projectJournal of Hospice & Palliative Nursing; by Joan G Carpenter, Julianne Murthi, Molly Langford, Ruth Palan Lopez; 3/26/24, online ahead of print This article describes a quality improvement project implemented by a national postacute long-term care organization aimed at enhancing the provision of palliative care to nursing home residents. ... Most common symptoms that were managed included pain, delirium, and dyspnea; most common diagnoses cared for were dementia and chronic organ failure (eg, cardiac, lung, renal, and neurological diseases).