Literature Review

“I Don’t Know What to Say”-A multimodal educational and environmental intervention to improve bedside nursing communication at end of lifeJournal of Hospice & Palliative Nursing; Wolownik, Gregory DNP, AGPCNP-BC, ACHPN; Wholihan, Dorothy DNP, AGPCNP-BC, ACHPN, FPCN, FAAN; 4/25... research shows inpatient medical-surgical nurses are not adequately trained to deliver end-of-life (EOL) care. This lack of foundational learning leads to gaps when communicating with patients and families and negatively impacts quality of care. A literature review and staff interviews identified barriers to communication, such as lack of formal education and experience; personal, cultural, and emotional challenges; and high workload. A multimodal intervention focusing on improving staff nurse communication skills was designed ...[including] environmental cues, engaging pocket cards, and an education module on communication techniques. Nurses demonstrated increased confidence and competence immediately following the education session, enduring at 4 weeks. Innovative, clinically relevant interventions can positively impact communication skills without requiring increased time commitments or high cost.

Heart & Soul: Nikki HarrisCharleston Area Medical Center, Charleston, WV; 4/8/25 Nikki Harris is a Charge Nurse on 4 West at Memorial Hospital. Harris’ coworkers say she always provides excellent care but went out of her way for one man who wasn’t even her patient. The man’s wife was near the end of life in Hospice at Memorial Hospital. He had not been able to see or visit her since his own hospitalization. Recognizing the importance of this moment, Harris went above and beyond by personally escorting him to his wife’s side. She ensured that he had the time he needed to hold her hand, express his love and say goodbye before her passing. Harris’ compassion and selflessness in providing this extraordinary gesture of care during such a difficult time was deeply appreciated. She made a meaningful difference in this patient’s life and honored the final moments of his wife’s life.

A hospice nurse made a promise—and found homes for 1,300 pets  Miami Herald, Miami, FL; by Jen Reeder; 4/7/25Working as a hospice nurse, Joanne Bonicelli spent years offering comfort to dying people. Then, in 1998, a request from one patient changed her life. A young woman in her 40s had a fluffy white dog named Jasper, who never left her side while she was at Pikes Peak Hospice & Palliative Care in Colorado Springs, Colorado.  One day, the woman called Joanne to her bedside. “I don’t know where Jasper will end up or who will care for him when I am gone…it’s just too painful to bear,” she told Joanne as tears streamed down her face. “I can’t die in peace worrying what will happen to him…can you euthanize him in my arms as I pass?” The heart-wrenching request stunned Joanne. She asked a veterinarian about what they could do, and after meeting Jasper, the vet’s eyes welled with tears at the prospect of putting down a healthy dog. There has to be a better way, they both agreed. [Continue reading ...]

2 nursing staff practices tied to safety risks: Study Becker's Clinical Leadership, Washington, DC; by Mariah Taylor; 4/3/25 Washington, D.C.-based George Washington University and Premier researchers found overreliance on agency nurses and nurse overtime was associated with lower patient safety. The study, published April 2 in JAMA Network Open, analyzed data on quality measures for pressure ulcers and nurse staff overtime and agency use from 70 U.S. hospitals from January 2019 through December 2022. Researchers found that nearly half of the hospitals in the study utilized more nurse overtime and agency hours than was safe. The average hours exceeding safe thresholds for agency staff reached 140% and 63.6% for nurse overtime. Overuse of agency nurses and overtime hours was associated with increased rates of pressure ulcers. [Continue reading ...]

A dying wish: Man with terminal cancer travels to volunteer in all 50 states ABC-7 News, Bay Area, CA; by 4/6/25 When Doug Ruch was told he had just 12 to 18 months to live, he didn't choose to stay home. Instead, he hit the road - on a mission to help as many people as possible while he still can. "I thought to myself, I have two choices. I can sit at home and wait to die, or I can go out and live," he told ABC7 News. [Continue reading ...] Editor's note: For more, visit Doug's website, www.dyingtoserve.com.

‘The most someone wants is to be heard’: Students foster connection, create memoirs for hospice patients The Daily Texan - University of Texas, Austin, TX; 4/3/25 ... Brought to UT in 2023, Last Writers is a service organization where student volunteers interview hospice patients over the course of several months to write a memoir that is then printed and given to the patients and their families. The process is intended to bring comfort to hospice patients and create a physical memento for the families, representing their lives once they pass. ... “It’s not often that you’re a college student and you get to meet someone who is going to pass away in the next few months,” Nguyen said. “To be with them in that very vulnerable point, it gives you a lot of perspectives. A lot of our members come out of it realizing how much they have to live for. … It makes us more grateful in life and puts our mortality into perspective.” [Continue reading ...]

A rapid review of psychedelic-assisted therapy in the context of palliative careJournal of Hospice & Palliative Nursing; Miller, Megan PhD, RN; Meyers, Molly BSN, RN; Martin, Annona MSc; Napolitano, Stephanie MA, LMHC; Dorsen, Caroline PhD, FNP-BC; Penn, Andrew MS, PMHNP; Rosa, William E. PhD, MBE, APRN, FPCN; 4/25Psychedelic-assisted therapy (PAT) involves supported experiences with psychedelic medicines in carefully curated environments. Results support safety and initial efficacy of PAT for psycho-spiritual-existential outcomes among carefully screened and highly homogonous samples of patients with serious illness (predominantly cancer). Additional work is needed to (1) explore PAT's safety and efficacy within more diverse samples and contexts, (2) train palliative care providers on PAT, (3) determine systems of care delivery best suited for translation of PAT into practice, and (4) begin developing policy solutions to support safe and equitable access to PAT. Because many patients lack access to basic psychosocial-spiritual-existential care, careful consideration is needed around integration of PAT. The psychedelic substances which are the topic of this article are not currently FDA approved for use in the United States.

Hospice of the Chesapeake leader aims to think outside the box on hospice, palliative care McKnights Home Care; podcast by Liza Berger with Rachel Jordan; 3/27/25 As the director of legislative affairs and advocacy at Hospice of the Chesapeake, the largest independent not-for-profit hospice provider in the state of Maryland, Rachel Jordan strives to treat the patient and not the disease. This helps explain why she worries less about the line between “curative” and “noncurative” care and more about whether a particular treatment helps to make a patient feel more comfortable. Jordan spoke to McKnight’s Home Care about her views of hospice and palliative care for a Newsmakers podcast. [Continue to the podcast ...]

What to know about palliative and hospice care Association of Health Care Journalists (AHCJ); by Liz Seegert; 3/28/25 ... [Palliative care] is fundamental to health and human dignity and is a basic human right, according to the FXB Center for Health and Human Rights at Harvard.  When reporting on serious illnesses, journalists can help demystify palliative care and encourage more people in need to take advantage of it by clearly explaining the differences, and benefits, and incorporating anecdotes to further illustrate how these types of care make a difference in the lives of patients and their families. [Continue reading ...] Editor's note: Share this article--written for health care journalists--with your communications and marketing leadership, with your community newspapers' journalists, and your employee/volunteer educators. Too often, new hospice/palliative care employees at all levels of roles and responsibilities begin their roles without clear knowledge, comprehension, and application of distinctions between standard healthcare, palliative care, and hospice care.  

Honoring a young girl’s love of nature on her final dayMayo Clinic News Network; by Mayo Clinic Staff; 3/27/25 On a Saturday evening in September of 2024, Mae Helgeson arrived at Mayo Clinic in Rochester, her small body reeling from the trauma of a life-threatening accident. Although she was intubated and sedated, it didn't take long for the care team to learn what made this little girl special. ... "I often ask parents to tell me about their child. Is there anything you think is important or that I should know about your family?" says Paige Dighton, one of the Child Life specialists who partnered with Mae's family. "This allows them to share the special things — those unique qualities that make them a family. You learn more than just what's in their chart." ... It was only a couple of days later that Mae's family was faced with the devastating decision they'd hoped to avoid. ... The question shifted from "Can we save her?" to "How do we say goodbye?" Following their lead, the team began focusing on end-of-life care. "Dr. Schiltz gave us the space to think and process our emotions — it didn't feel rushed," says Matt. 

Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support Cureus; by Taposh P. Dutta Roy; 3/12/25 Healthcare professionals face complex ethical dilemmas in clinical settings in cases involving end-of-life care, informed consent, and surrogate decision-making. These nuanced situations often lead to moral distress among care providers. This paper introduces the Bioethics Artificial Intelligence Advisory (BAIA) framework, a novel and innovative approach that leverages artificial intelligence (AI) to support clinical ethical decision-making. The BAIA framework integrates multiple bioethical approaches, including principlism, casuistry, and narrative ethics, with advanced AI capabilities to provide comprehensive decision support. 

Population-based payments to deliver health care to unhoused individualsJAMA Health Forum; Sudhakar V. Nuti, MD, MSc; Amanda K. Johnson, MD, MBA; Theodore Long, MD, MHS; 3/25The 770,000 people experiencing homelessness in the US have a high prevalence of disease and high health care utilization. Compared to the general population, unhoused individuals in the US have a 3.5 times higher mortality rate and 27-year reduced life expectancy. To this end, we propose population-based payment models (PBPs) as a novel mechanism to provide increased, stable, and predictable funding for health care for unhoused individuals. PBPs are the most advanced category of value-based alternative payment models, where health care organizations are given a prospective payment to care for a population of patients, with the flexibility to tailor care without incentivizes to optimize billable encounters, while being held accountable for improved outcomes and costs. The flexibility in how to invest and earn funding is essential for focused investment in these models, as increased reimbursement alone is insufficient.

Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of CardiologyEuropean Journal of Heart Failure; Maurizio Volterrani, Geza Halasz, Stamatis Adamopoulos, Pier Giuseppe Agostoni, Javed Butler, Andrew J.S. Coats, Alan Cohen-Solal, Wolfram Doehner, Gerasimos Filippatos, Ewa Jankowska, Carolyn S.P. Lam, Ekaterini Lambrinou, Lars H. Lund, Giuseppe Rosano, Marco Metra, Stefania Paolillo, Pasquale Perrone Filardi, Amina Rakisheva, Gianluigi Savarese, Petar Seferovic, Carlo Gabriele Tocchetti, Massimo Piepoli; 3/25 Patients with heart failure (HF) experience much worse QoL [quality of life] and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. The importance of QoL for patients with HF is highlighted in a survey showing that 61% attached more weight to QoL over longevity, with 9% and 14% willing to trade 6 and 12 months, respectively, for perfect health and better QoL.It is for these reasons that the Heart Failure Association is developing a new score for QoL in HF, sensitive to mechanism-specific interventions and tailored to be sensitive to changes within individual patients.