Literature Review
All posts tagged with “Clinical News | Physician & Nursing News.”
My dad had an Advance Directive. He still had to fight to die
08/27/24 at 03:00 AMMy Dad had an Advance Directive. He still had to fight to die Newsweek - My Turn; by Maggie Schneider Huston; 8/26/24 My mom died peacefully. My dad died 72 days later, angry at the doctors for ignoring his wishes. ... Dad had heart surgery on December 20, 2023. An hour after the surgery ended, his vital systems started shutting down. A cascade of interventions, one after another, kept him alive. Four days later, he said: "Put me on hospice." The doctor dismissed this request, rolling his eyes and saying: "Everyone on a ventilator says that." On Christmas Day, my father asked for hospice again. He was in pain. He knew his recovery would be long and ultimately futile. He would never have an acceptable quality of life again. ... Dad's care team insisted palliative care was the same as hospice care, but he knew the difference. He wanted hospice care. Finally, they reluctantly agreed and called for a social worker to make arrangements. It wasn't necessary. Once they removed his treatment and relieved his pain, he died five hours later. ... Editor's Note: This article is not about Medical Aid in Dying (MAiD). It is about honoring Advance Directives, person-centered care with communications and actions related to "palliative" vs. "hospice" care.
Avoid these mistakes in palliative care to enhance your loved one's well-being
08/27/24 at 02:00 AMAvoid these mistakes in palliative care to enhance your loved one's well-being Leesville Leader, Lake Charles, LA; by Evertise Digital; 8/26/24 For people with life-threatening diseases, palliative care is crucial in providing comfort and improving quality of life. It’s essential to focus on the details and avoid common mistakes in order to deliver good treatment. Mistakes in palliative care can inadvertently cause discomfort or diminish the quality of the support provided. It’s critical to recognize and steer clear of certain mistakes to guarantee that your loved one receives the finest treatment possible. By focusing on these key areas, you can enhance their well-being and provide the compassionate, attentive care they need during this challenging time.
Dr. Joe Rotella, AAHPM: The importance of being human – Reflections of an aspiring medical humanist
08/26/24 at 03:00 AMDr. Joe Rotella, AAHPM: The importance of being human – Reflections of an aspiring medical humanist American Academy of Hospice and Palliative Medicine; Event Details; retrieved from the internet 8/23/24The Importance of Being Human - Reflections of an Aspiring HumanistDate: September 17, 2024Time: 4:00 pm - 5:00 pm CTGrand Rounds free; Non-Members $49.00 USD
The importance of competencies in pain management and palliative care
08/23/24 at 03:00 AMThe importance of competencies in pain management and palliative care Greenwich Sentinel, Greenwich, CT; by Russell R. Barksdale, Jr.; 8/21/24 ... Competencies, ongoing pharmacological education, regular patient pain assessments, management, and medication adjustments are all crucial processes for healthcare providers in today’s complex medical environment. Regrettably, metabolic and behavioral issues related to pain medications, especially opioids, if not properly managed, poses risk of addiction. Beginning in the late 1990s, the consumption of medical opioids used to treat pain increased in many countries worldwide. Since that time, alarmingly the United States has outpaced every other country in per capita opioid consumption. ... [Click on the title's link to continue reading.]
West Penn Hospital union nurses vote to authorize strike
08/23/24 at 03:00 AMWest Penn Hospital union nurses vote to authorize strike WPXI.com news, Pittsburgh, PA; by Taylor Spirito; 8/22/24 Union nurses at West Penn Hospital have voted to authorize a strike. On Wednesday, union nurses votes 99.3% in favor of authorizing their negotiating committee to send a strike notice if necessary, rejecting contract proposals from the Allegheny Health Network (AHN) as inadequate to address the region’s nurse staffing crisis. The nurses are calling for resources to recruit new nurses and retain experienced ones. They said the hospital’s nursing staff must obtain 100 more registered nurses to meet the region’s growing patient care needs, a representative from SEIU Healthcare PA said.
Hospice Insights Podcast - Stories of successful hospice leadership: The CEO and Chief Medical Officer relationship
08/23/24 at 03:00 AMHospice Insights Podcast - Stories of successful hospice leadership: The CEO and Chief Medical Officer relationship JD Supra; by Husch Blackwell; 8/21/24 A strong and engaged Chief Medical Officer (CMO) may be a hospice CEO’s most important asset. But what does a successful CEO/CMO relationship look like and how must it evolve to meet today’s challenges? In this episode we get to find out, as Husch Blackwell’s Meg Pekarske is joined by HopeHealth CEO Diana Franchitto and Dr. Edward Martin, CMO, whose trusted relationship has been instrumental to the organization’s success and clinical expansion.
Bioethicists scrutinize Pontifical Academy for Life’s new guidance on withdrawing food, water
08/21/24 at 03:00 AMBioethicists scrutinize Pontifical Academy for Life’s new guidance on withdrawing food, water The Catholic World Report; by Jonah McKeown; 8/16/24 After the Pontifical Academy for Life (PAFL) last month issued a booklet summarizing the Church’s teaching on a number of bioethical issues, the section on “artificial nutrition and hydration” (ANH) has some observers concerned about what they see as a departure from previous Church teaching. ... The Church’s teaching on this issue was recently in the news in the United States because of the ongoing case of Margo Naranjo, a disabled Texas woman whose parents, who are Catholic, announced last month that they had decided to allow Margo to die by starvation in hospice. They were prevented from doing so after a judge intervened. ... What does the Pontifical Academy's new document say? ... “[T]he doctor is required to respect the will of the patient who refuses them with a conscious and informed decision, also expressed in advance in anticipation of the possible loss of the ability to express himself and choose,” the PAFL wrote. he PAFL noted that Pope Francis has emphasized the importance of considering the whole person, not just individual bodily functions, when making medical decisions.Editor's Note: This "guidance" and discussion is much more complex than the summarized information above. Click on the title's link to read more.
Hospice physician’s convictions and $15 million in restitution affirmed for ‘pervasive’ fraud
08/21/24 at 02:00 AMHospice physician’s convictions and $15 million in restitution affirmed for ‘pervasive’ fraud CCH Incorporated; by Justin Marcus Smith, J.D.; 8/15/24 The Fifth Circuit found it circumstantially telling that the jurors saw multiple hospice patients testifying at trial nearly a decade after the convicted physician had recommended them for end of life care. In an unpublished opinion, the United States Court of Appeals for the Fifth Circuit affirmed a physician’s conviction for conspiracy to commit health care fraud and for seven individual counts of healthcare fraud in connection with hospice care service recommendations. Applying de novo review, the court affirmed the convictions on the basis that the government presented enough circumstantial evidence, without direct evidence of intent, for a reasonable jury to have found guilt. With respect to sentencing, the circumstances surrounding 7,000 hospice claims formed a basis for fraud so pervasive that the government did not need to “sift” through each of the claims.
Medical marijuana study details Arkansans’ use of the drug, raises questions from lawmakers
08/20/24 at 03:00 AMMedical marijuana study details Arkansans’ use of the drug, raises questions from lawmakers Arkansas Times; by Tess Vrbin for the Arkansas Advocate; 8/15/24 ... The study, conducted by the Arkansas Center for Health Improvement, is the first ever population-based study of medical marijuana funded by a federal health agency, the National Institutes of Health. ... The state currently has more than 105,000 cardholders, an increase of roughly 29,000 in three years, according to ACHI’s study. ... Lawmakers on the Joint Public Health, Welfare and Labor Committee ... expressed concerns about some of the information in the study, such as the fact that one-third of the certifications for medical marijuana cards in 2021 came from just seven doctors, with little evidence of a physician-patient relationship in many cases.Thirty-eight states and the District of Columbia have legalized marijuana to some extent, and Arkansas is one of 14 states in which the drug is legal only for medicinal purposes.
4 ways health systems combat burnout
08/19/24 at 03:00 AM4 ways health systems combat burnout Becker's Hospital Review; by Kristin Kuchno; 8/13/24 Although burnout is down among healthcare professionals, its persistence still garners attention and solutions from systems. Physician burnout fell from 53% in 2022 to 48.2% in 2023, according to a July 2024 report by the American Medical Association. ... Here are four methods four hospitals and health systems are using to address workforce burnout.
Dr. Oswalt on the effects of palliative care timing on end-of-life care in mNSCLC
08/19/24 at 03:00 AMDr. Oswalt on the effects of palliative care timing on end-of-life care in mNSCLC OncLive, Oncology Specialty Group; by Cameron James Oswalt, MD; 8/15/24 Cameron James Oswalt MD, fellow, Hematology-Oncology, assistant professor, medicine, Department of Medicine, Duke University School of Medicine, discusses findings from a study evaluating the timing of palliative care referral and its effect on end-of-life care outcomes in patients with metastatic non–small cell lung cancer (mNSCLC). ... Investigators found that fewer than half of patients received palliative care during their treatment course, and fewer than one-third of the patients who received palliative care accessed this care within 2 months of diagnosis, ... The low referral rate in this cohort could be attributed to several factors, including patient preferences, preconceived notions, barriers to referral, and overall disease burden, he says. Among patients who died, 59.1% were enrolled in hospice.
Person-centered, goal-oriented care helped my patients improve their quality of life
08/16/24 at 02:15 AMPerson-centered, goal-oriented care helped my patients improve their quality of life Journal of the American Board of Family Medicine; by Lee A. Jennings and James W. Mold; orignially posted 5/24 issue, again on 8/15/24 When the goal is to help patients improve their quality of life, it makes sense to focus directly on the activities and relationships that are most important to each patient. This can be accomplished most effectively by following a three-step process that includes 1) connecting with the patient around what matters to them, 2) co-creating a goal-oriented plan, and 3) collaborating with patient, family, team members, and consultants to increase the probability of success. Once this approach has been mastered and the necessary systems, processes, and relationships are in place, this should not take more time than a problem-oriented approach, and it will almost certainly be more satisfying for both physician and patient. Editor's Note: Simple. Effective. Meaningful.
Hospice and Palliative Nurses Foundation receives $1.2 million impact grant
08/16/24 at 02:00 AMHospice and Palliative Nurses Foundation receives $1.2 million impact grant Hospice & Palliative Nurses Association (HPNA); August 2024 newsletter, with webpage posted 7/8/24 The Hospice and Palliative Nurses Foundation (HPNF) is thrilled to announce that it has been awarded a transformative $1.2 million impact grant from the Hospice and Palliative Credentialing Center (HPCC). The Sandra Lee Schafer Impact Grant, given in memory of the late Sandra Lee Schafer, MN, RN, AOCN®, will empower HPNF to create a legacy of sustainable giving, which will impact the hospice and palliative care community for years to come. “We are deeply honored and grateful to receive this impact grant from HPCC, given in tribute of Sandy,” said Virginia (Ginger) Marshall, MSN, ACNP-BC, ACHPN®, FPCN, chief executive officer of HPNF. Sandra was an unwavering advocate of specialty nursing certification. ... Sandra served as the director of credentialing of the Hospice and Palliative Credentialing Center from 2004 until her sudden passing in 2018.
‘The Last Ecstatic Days’ one day screening strives to teach the world how to die without fear
08/15/24 at 03:00 AM‘The Last Ecstatic Days’ one day screening strives to teach the world how to die without fear Bangor Daily News, Bangor, ME; by BDN Community; 8/13/24 Hospice Volunteers of Waldo County invites Greater Waldo County to a single night screening on Tuesday, Aug. 20 at 7 p.m. Post-screening, there will be a Community Conversation with Hospice and Palliative Care Physician Aditi Sethi, MD and Director of the Center for Conscious Living & Dying/Hospice Volunteers of Waldo County’s Flic Shooter. Sethi, MD’s end-of-life palliative work is featured in the film. “The Last Ecstatic Days” focuses on a young man with terminal brain cancer (Ethan Sisser) as he sits alone in his hospital room. When Sisser starts live-streaming his death journey on social media, thousands of people around the world join to celebrate his courage. Still, he envisions more–to teach the world how to die without fear. To do that, Sisser needs to film his actual death. What unfolds next is a rarely-glimpsed perspective of how a community of strangers helps a young man die with grace.Editor's Note: This movie has been featured on PBS. The Boston Globe describes, "... courageous end-of-life chronicle, which overflows with compassion." The Louisiana Mississippi Hospice & Palliative Care Organization shared this as a viewing and discussion at their July 2024 conference. For the trailor and more information, click here.
Examining the relationship between rural and urban clinicians’ familiarity with patients and families and their comfort with palliative and end-of-life care communication
08/15/24 at 03:00 AMExamining the relationship between rural and urban clinicians’ familiarity with patients and families and their comfort with palliative and end-of-life care communication
Virtual palliative care improves quality of life in advanced lung cancer
08/15/24 at 03:00 AMVirtual palliative care improves quality of life in advanced lung cancer MedPage Today; by Greg Laub; 8/13/24 In this exclusive MedPageToday video, Roy Herbst, MD, PhD, of Yale Cancer Center in New Haven, Connecticut, discusses a studyopens in a new tab or window presented at the recent American Society of Clinical Oncology (ASCO) meeting, which showed that patients with advanced non-small cell lung cancer receiving palliative care via video consultation had outcomes comparable to those treated in person. Following is a transcript of his remarks: ...
3 components of virtual nursing
08/15/24 at 03:00 AM3 components of virtual nursing MarketScale, Dallas, TX; by David Jastrow; 8/12/24 As healthcare adopts digital innovations, virtual nursing is increasingly significant. This study delves into the key components driving this transition, analyzing the benefits, and exploring future trends. [The 3 key components identified include:]
Death is inevitable. It's time we learned to talk about it.
08/15/24 at 03:00 AMDeath is inevitable. It's time we learned to talk about it. MedPageToday; by Nidhi Bhaskar; 8/13/24 By fostering honest and compassionate discussions, we can provide patients with more dignity. Years ago, in a busy emergency department, I found myself joining my mentor at the bedside of an elderly man experiencing chest pain. After completing the physical exam, the doctor unceremoniously changed gears to abruptly ask our patient, "If your heart were to stop beating, do you want us to do everything?" Between the stress of the situation and the vague and awkward delivery of the question, our patient seemed (understandably) overwhelmed. So was I. ... End-of-life conversations can feel like a "word soup" of sorts ... it is easy for patients and providers alike to feel lost. ... Providers must also consider the nuances of cultural attitudes towards death; the location and family arrangements surrounding a person at the end of life; and the varying emotional responses and feelings of decision paralysis surrounding how one dies and how one feels about dying.Editor's Note: For a related article in our newsletter today, read "Examining the relationship between rural and urban clinicians’ familiarity with patients and families and their comfort with palliative and end-of-life care communication."
9 powerful lessons on life you can learn from experts on death
08/13/24 at 03:00 AM9 powerful lessons on life you can learn from experts on death Forbes; by Robert Pearl, MD; 8/12/24 As a physician, I have been present at the end of many lives, witnessing the profound agony families face during a loved one’s final moments. While most family members express deep gratitude for the care provided by doctors and nurses, some recount harrowing stories of unnecessary pain their loved ones endured in the final days. These distressing accounts highlight a troubling ambiguity in the care we provide, blurring the line between compassionate treatment and what can feel like unbearable torture. Motivated by my encounters with grieving families, I dedicated the ninth season of the Fixing Healthcare podcast to exploring life’s final chapter and addressing the shortcomings in end-of-life care. ...
Dr. El-Jawahri on the impact of palliative care on end-of-life care for AML and MDS
08/13/24 at 03:00 AMDr. El-Jawahri on the impact of palliative care on end-of-life care for AML and MDS OncLive; by Areej R. El-Jawahri, MD; 8/12/24 Areej El-Jawahri, MD, associate director, Cancer Outcomes Research and Education Program, director, Bone Marrow Transplant Survivorship Program, associate professor, medicine, Massachusetts General Hospital, discusses findings from a multi-site, randomized trial (NCT03310918) investigating a collaborative palliative oncology care model for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) receiving nonintensive therapy at 2 tertiary care academic hospitals. Patients in the study who received the palliative care interventions had a median of 41 days from end-of-life care discussions to death, compared with 1.5 days in the standard care group (P < .001). Additionally, patients who received the palliative care interventions were more likely to articulate their end-of-life care preferences and have these preferences documented in electronic health records, El-Jawahri begins. This documentation correlated with fewer hospitalizations in the final 30 days of life, she notes. Furthermore, palliative care recipients experienced QOL improvements and a trend toward reduced anxiety symptoms vs the patients who received usual care, El-Jawahri says. These findings underscore the necessity of integrating palliative care as a standard of care for patients with AML and high-risk MDS, El-Jawahri emphasizes.
Alzheimer’s prognosis models should expand data sources
08/13/24 at 02:00 AMAlzheimer’s prognosis models should expand data sources McKnights Senior Living; by Kristen Fischer; 8/12/24 Integrating data from nursing home electronic health records and claims in addition to the minimum data set — data required for nursing home residents — could be better than just relying on the MDS sources to produce an accurate prognosis for nursing home residents with Alzheimer’s disease and related dementias, according to a report published Thursday in the Journal of the American Geriatrics Society. ... The authors of the report noted that a recent review of prognostic models for late-stage ADRD found that assessments commonly used to evaluate prognosis-based eligibility for hospice weren’t reliable. ... Only 15% of people enrolled in hospice have a primary diagnosis of ADRD. That’s because it’s challenging to estimate the six-month prognosis required to be eligible for hospice, and dementias have a prognosis of 12 to 18 months when they are in the late stage, the authors pointed out.
Nursing strategies to mitigate separation between hospitalized acute and critical care patients and families: A scoping review
08/03/24 at 03:25 AMNursing strategies to mitigate separation between hospitalized acute and critical care patients and families: A scoping review Intensive Critical Care Nurse; Sonja Meiers, Véronique de Goumoëns, Lorraine Thirsk, Kristen Abbott-Anderson, Petra Brysiewicz, Sandra Eggenberger, Mary Heitschmidt, Blanche Kiszio, Natalie S Mcandrew, Aspen Morman, Sandra Richardson; 7/26/24 Implications for clinical practice: Permanent policy changes are needed across acute and critical care settings to provide support for nurses in mitigating patient and family separation. We recommend that family members be considered as caregivers and care receivers, not visitors in patient and family-centered care in acute and critical care settings.
Prognostication in hospice care: Challenges, opportunities, and the importance of functional status
08/03/24 at 03:10 AMPrognostication in hospice care: Challenges, opportunities, and the importance of functional statusFederal Practitioner - Case Reports; by David B. Brecher, MD and Heather J. Sabol, MSN, ARNP; 7/24 Predicting life expectancy and providing an end-of-life diagnosis in hospice and palliative care is a challenge for most clinicians. Lack of training, limited communication skills, and relationships with patients are all contributing factors. These skills can improve with the use of functional scoring tools in conjunction with the patient’s comorbidities and physical/psychological symptoms. The Palliative Performance Scale (PPS), Karnofsky Performance Scale (KPS), and Eastern Cooperative Oncology Group Performance Status Scale (ECOG) are commonly used functional scoring tools.
Resources for people coping with Alzheimer’s disease
08/02/24 at 03:00 AMResources for people coping with Alzheimer’s disease Everyday Health; by Pamela Kaufman; updated 7/29/24 No one should have to deal with Alzheimer’s alone. The government agencies, nonprofit groups, and other resources listed here can help people with Alzheimer’s and their caregivers cope with the disease through education, advocacy, support services, clinical trial opportunities, and blogs that share the wisdom of lived experience. [This essential list of resources includes:]
Amid trauma and burnout, it ‘takes courage’ to reflect on mental, emotional well-being
08/02/24 at 03:00 AMAmid trauma and burnout, it ‘takes courage’ to reflect on mental, emotional well-being Healio; by Jennifer Byrne; 7/31/24 ... [William E. Rosa, PhD, MBE, MS] began to realize that in the stressful, devastating situations he and his colleagues faced daily, there was much to be learned from the principles of trauma-informed care. ... “This is the idea that cultivating an awareness can prevent us from re-traumatizing ourselves and others,” he said. “I think it starts with reflecting on — and telling the truth about — our mental and emotional well-being. That takes courage.” In acknowledging the emotional scars, brokenness and vulnerability that comes from tragedy and loss, individuals can begin to heal a lifetime of stored and unresolved trauma, Rosa said. “As a workforce, you and I see unacceptable rates of suicide, burnout, moral distress and attrition,” he said. “It’s time that we come to safe and supported terms with our trauma — not just as individuals, but as a collective, not only for the patients and families we serve, but for us to survive.”Editor's Note: In this article, Dr. Rosa identified "the emotional impact of taking yet another patient off the ventilator at the end of life." Recent articles we've posted in this newsletter about trauma-informed care been in our "Top Reads." While those articles focused on trauma-informed care of the persons you serve, this focuses on the persons who serve, your all-important direct patient care clinicians.