Literature Review

Medical 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 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.

Hospice 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.

3 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:]

Virtual 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: ... 

Dr. 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 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.

Prognostication 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.

Amid 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.

Resources 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:]

Physician pioneer in medical ethics dies: Howard Brody, MD, PhD Becker's Hospital Review; by Mariah Taylor; 7/29/24 Howard Brody, MD, PhD, a pioneer in the field of medical ethics, died July 22 at 75, KnoxTNToday.com reported July 29. Dr. Brody earned doctorates in both medicine and philosophy and specialized in topics such as medical ethics, end-of-life care and the placebo effect. He practiced family medicine and served as director of the Institute for the Medical Humanities at the University of Texas Medical Branch at Galveston, as well as director of the Center for Ethics and Humanities in the Life Sciences at East Lansing-based Michigan State University. Dr. Brody is survived by his wife and two children. 

Proactive fall prevention: Elevating patient safety and healthcare excellenceHealthCare Business News; by Amy Hester; 7/26/24... The significance of fall prevention cannot be overstated, as it directly impacts patient outcomes and overall healthcare quality. With the patient safety solutions market growing at an expected rate of 11.2%, the importance of proactive fall prevention strategies becomes even more evident. ... In the United States, preventable medical errors, including falls, are the third leading cause of death. The impact of falls on patient health and recovery is profound, often leading to longer hospital stays, delayed recovery and increased risk of subsequent falls.Editor's Note: Proactive fall prevention is especially important for persons needing palliative or hospice care. As the person's health and mobility declines, they have to adjust to these changes mentally, emotionally, physically, and relationally. Recognizing decline can feel like defeat. Asking for help can be tough. Family members can expect the person to move more independently more than possible, leading to falls.