Literature Review

Caregiver charged with abusing dementia patient The Freeman, Waukesha County, WI; by Freeman Staff; 7/9/24 A West Allis woman has been charged after she allegedly struck a dementia patient in her care and put a pillow over the woman’s face out of frustration. Erica Junger, 22, was charged Monday in Waukesha County Circuit Court with a count of intentionally abusing a patient, and faces up to six years in prison if convicted. She made an initial appearance in court Monday, where she was released on a $2,500 signature bond and ordered by Court Commissioner David Herring not to work in any job where she is responsible for the health care and safety of others. ... She said she "snapped" and did things she wasn’t supposed to do, but didn’t mean anything by it. ... The complaint did not identify the facility where the incident took place. But it did identify Junger as an employee of Agrace Hospice, which contracts with the facility.

Provider of in-home imaging services and 24/7 radiologist access raises $200M Radiology Business; by Marty Stempniak; 7/9/24 HarmonyCares, a provider of in-home X-ray services that spans 15 states, has raised $200 million in new capital, leaders announced Monday. Based in Nashville, Tennessee, the company is focused on physician-led care for vulnerable patients who cannot travel to a traditional healthcare facility. HarmonyCare Diagnostics brings the latest digital X-ray technology to patients’ homes or long-term care facilities, offering rapid results with board certified radiologists “available 24/7.”

Hospice and Palliative Nurses Foundation receives $1.2 million impact grant Cision PR Newswire; by Hospice and Palliative Nurses Foundation; 7/8/24The 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. Following a stellar nursing career, Sandra served as the director of credentialing of the Hospice and Palliative Credentialing Center from 2004 until her sudden passing in 2018.

How rituals support nursing teams American Nurse Journal - American Nurses Association; by Heather Fitzgerald, DBe, MS, RN; 7/2/24Question: I’m a clinical manager for a pediatric critical care unit. We’ve recently had a significant increase in end-of-life care. I’m proud of our nurses and the skillful, compassionate support they provide to patients and families during these tragic events. In an emotional support debrief, nurses expressed a desire for more opportunities to pause and reflect on meaning and purpose in their challenging work. How do I regularly schedule time to support nurses in ways they value while also adhering to our organization’s budget and productivity expectations? Answer: ... creating a supportive sense of community and connection need not violate your commitment to budget management. You can enact opportunities to orient to meaning and purpose, to shared identity and belonging, and to unit and organizational mission through small rituals that deliver benefits similar to your debriefing forum. Rituals ... have deep, prehistoric roots, which indicate that humans have long sought connection and meaning-making in moments of joy, grief, and uncertainty. Nurses participate in patient-centered rituals in various settings. For example, organ donor honor walks, the ringing of a bell to mark a cancer treatment milestone, discharge celebrations after a long hospitalization, and celebrations of life and of birth. The nursing profession also should pay more attention to the importance of nursing-centered rituals.Editor's Notes: Nurse burnout is a root cause for both high turnover and increased unionization/strikes among nurses, especially nurses in their first year of practice. What nursing-centered ritual(s) might bring meaning and renewal to your nurses? Ask. Create, pilot, and evaluate. Engage them in the process.  

Clinician- and patient-directed communication strategies for patients with cancer at high mortality risk JAMA Network Open - Oncology; by Samuel U. Takvorian, MD, MSHP; Peter Gabriel, MD, MSE; E. Paul Wileyto, PhD; Daniel Blumenthal, BA; Sharon Tejada, MS; Alicia B. W. Clifton, MDP; David A. Asch, MD, MBA; Alison M. Buttenheim, PhD, MBA; Katharine A. Rendle, PhD, MSW, MPH; Rachel C. Shelton, ScD, MPH; Krisda H. Chaiyachati, MD, MPH, MSHP; Oluwadamilola M. Fayanju, MD, MA, MPHS; Susan Ware, BS; Lynn M. Schuchter, MD; Pallavi Kumar, MD, MPH; Tasnim Salam, MBE, MPH; Adina Lieberman, MPH; Daniel Ragusano, MPH; Anna-Marika Bauer, MRA; Callie A. Scott, MSc; Lawrence N. Shulman, MD; Robert Schnoll, PhD; Rinad S. Beidas, PhD; Justin E. Bekelman, MD; Ravi B. Parikh, MD, MPP; 7/1/24 Serious illness conversations (SICs) that elicit patients’ values, goals, and care preferences reduce anxiety and depression and improve quality of life, but occur infrequently for patients with cancer. Behavioral economic implementation strategies (nudges) directed at clinicians and/or patients may increase SIC completion. ... In this cluster randomized trial, nudges combining clinician peer comparisons with patient priming questionnaires were associated with a marginal increase in documented SICs compared with an active control. Combining clinician- and patient-directed nudges may help to promote SICs in routine cancer care.

Aligning pill burden and palliative care needs in late-stage CVD: AHA TCTMD - Cardiovascular Research Foundation; by L.A. McKeown; 7/2/24 The first scientific statement from the American Heart Association (AHA) that focuses specifically on pharmacotherapy considerations in the palliative management of patients with CVD [cardiovascular diesease] urges a patient-centered, compassionate approach to de-escalating and deprescribing. ... In addition to shedding light on how and when to start deprescribing and de-escalating common cardiovascular drugs, the statement discusses palliative drugs for pain, shortness of breath, and appetite in the context of CVD, which [Katherine E.] Di Palo [PharmD (Montefoiore Medical Center, NY)] said the committee identified as a gap in knowledge given that much of the evidence for these drugs comes from patients with serious illnesses like cancer. ... Important Takeaways: Di Palo and colleagues note that palliative care complements cardiovascular care in several important ways, including reducing physical symptom burden, managing emotional and spiritual distress, providing sufficient support for caregivers, and helping patients choose treatment in line with their goals for care. Editor's Note: Click here for the American Heart Association's statement, which we posted on 7/2/24. 

Anxiety and resilience in palliative medicine physicians BMJ Supportive & Palliative Care; by Cristhian Alexis Velásquez Marín, Carlos Javier Avendaño-Vásquez; 7/2/24, online ahead of printTo identify the relationship between the degree of anxiety and the capacity for resilience in palliative care physicians ..., [we] included 42 Colombian Palliative Care Physicians and administered a sociodemographic questionnaire, the Zung Anxiety Scale and the Resilience Scale. Results: 42 palliative care physicians with an average age of 41 participated in the study. Anxious symptoms were present in 100% of the physicians evaluated. Mild or moderate anxiety was identified in 93.7% of the population and 6.3% of people with severe anxiety symptoms. ... Our results reflect that the population of palliative care physicians has a higher risk and exposure to developing anxiety and its adverse outcomes. We found higher anxiety levels compared with other studies so this population requires greater vigilance and intervention in treating and preventing mental health difficulties.Editor's Note: Executive leaders for palliative care services, use this research to be aware of possible stress-related tolls on your palliative physicians and team members. Ask. Generate dialogue. Do not assume that this applies, but rather use it to tune into and improve the support your physicians need. While this research was in Columbia, it resonates a U.S.recurring trend of the unionization of physicians, often related to burnout and stress overload.

Muncie hospice nurse accused of obtaining narcotics 'by fraud or deceit' The Star Press, Muncie, IN; by Douglas Walker; 7/2/24 A Muncie hospice nurse is accused of ordering prescription pain medication in the names of nursing home residents who then never received the narcotics. Meredith Griffin Briles, 45, is charged in Delaware Circuit Court 5 with obtaining a controlled substance by fraud or deceit, possession of a narcotic drug and failure to make, keep or furnish a record. All three charges are Level 6 felonies carrying up to 30 months in prison.

Empowering ‘deeply undervalued’ caregivers would improve ‘lifeline for older adults’ McKnights Senior Living; by Kimberly Bonvissuto; 6/28/24 Direct care workers and family caregivers remain “deeply undervalued” and often overlooked despite calls for investment in the care economy, according to the authors of a new report. “These caregivers provide a lifeline for older adults, people with disabilities, and people living with chronic conditions,” PHI and the National Alliance for Caregiving said in an issue brief released Wednesday. “Empowering them in their roles will help to ensure high quality, responsive care to meet the needs and preferences of millions of Americans now and in the future.” The organizations called on providers, Congress, the Department of Labor, the Centers for Medicare & Medicaid Services, the federal Health Resources and Services Administration, states, managed care plans and advocates to invest in the “essential partnership” between direct care workers and family caregivers. The new brief includes insights from a variety of stakeholders ...  The result is a list of recommendations that prioritize improvements to direct care jobs.Editor's Note: Our sponsor, Composing Life Out of Loss, equips hospice and palliative care organizations with caregiver education and support video libraries to strengthen relationships between the direct care professional and the family caregiver, with timely information for the entire family. Contents are written to CMS CoPs, CAHPS, and contemporary grief research; English and Spanish.

[American Heart Association] Palliative care beneficial to manage symptoms, improve quality of life for people with CVD [cardiovascular disease] American Heart Association; by NewMediaWire; 7/1/24 Implementing patient-centered palliative care therapies, including prescribing, adjusting or discontinuing medications as needed, may help control symptoms and improve quality of life for people with heart disease, according to “Palliative Pharmacotherapy for Cardiovascular Disease,” a new scientific statement from the American Heart Association, published today in the Association’s journal, Circulation: Cardiovascular Quality and Outcomes. The new scientific statement reviews current evidence on the benefits and risks of cardiovascular and essential palliative medications. The statement provides guidance for health care professionals to incorporate palliative methods as part of holistic medication management at all stages of a patient’s health conditions, emphasizing the importance of shared decision-making and goal-oriented care.

AMA Advocacy 2024 efforts American Medical Association; by AMA; Updated June 2024, 6/27/24 There are far too many everyday practice challenges interfering with patient care. That’s why the American Medical Association is advocating to keep physicians at the head of the health care team, reform the Medicare physician payment system, relieve the burdens of overused prior authorizations and so much more. [Key advocacy efforts include:]

Story Rounds inspires real talk by doctors about their toughest work Standford Medicine - SCOPE Beyond the Headlines; by Mark Conley; 6/27/24 Jay Shah, MD, took a deep breath as he stood on the Berg Hall stage and looked out across the crowd. It was made up of 150 of his Stanford Medicine peers, some of them longtime mentors and collaborators. ... Shah had been chosen to lead off the latest rendition of Story Rounds, the WellMD and WellPhD and the Medical Humanities and Arts Program (MedMuse) co-sponsored live storytelling program -- a safe place for MDs, clinical students and residents to share with their colleagues. ... Shah's tale was an impassioned 13-minute story of metamorphosis: Of going from a doctor determined to trudge forward without self-reflection, watching it destroy his marriage and spiral his mental health, to one who recognized the harm in not processing the difficult situations and emotions that come with the job -- such as the pain, guilt and loneliness of losing a patient and feeling like it was all his fault. His was the first of five stories that evening, delivered in a personal storytelling format inspired by Public Radio Exchange's podcast The Moth. It encapsulated a growing movement toward doctors talking openly about burnout, stress and mental health -- and trying to support one another, whether they're a wide-eyed first-year resident or a veteran health care leader like Shah.

[Four-day workweeks:] A flexibility trend gaining steam in nursing Becker's Clinical Leadership; by Erica Carbajal; 6/26/24 A growing number of health systems are embracing  four-day workweeks for nurse leaders — a strategy that has helped some boost recruitment, retention and staff engagement. Over the past year, the needs and well-being of nurse managers have come into focus, with hospitals and health systems taking a closer look at how to best support them in addition to bedside nurses. Survey findings have indicated nurse managers have a hard time fully disconnecting from work, and they crave much of the same work environment factors that front-line nurses do, such as the ability to take time off when needed and work-life balance support. As such, four-day schedules have increasingly become part of the conversation at many hospitals and health systems.