Pilot Implementation of a Low-Literacy Zone Tool for Heart Failure Self-management
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: DEPARTMENTS: CE Tests Source Type: research

Silent Illumination: A Case Study Exploring the Spiritual Needs of a Transgender-Identified Elder Receiving Hospice Care
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: DEPARTMENTS: CE Tests Source Type: research

The Role of Palliative Care in Donation for Transplantation
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: DEPARTMENTS: HPNA Position Statement: The Role of Palliative Care in Donation for Transplantation Source Type: research

Exploring a Nursing Home–Specific Interdisciplinary Approach: Toward Palliative Care for the Demented and Complex-Disabled Elderly
The number of elderly suffering from dementia and complex disabilities is gradually increasing in nursing homes, and they form a differentiated group that requires palliative care provided by practitioners in various disciplines from the time of their admission to improve the quality of their remaining lives. The purpose of this study was to explore an interdisciplinary care approach by nurses and related practitioners for the demented and complex-disabled elderly in nursing homes that focuses on palliative care based on an ethical point of view. A qualitative thematic analysis was conducted through in-depth interviews of ...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Global Exemplar Series Source Type: research

The Need for Cultural Inclusivity in Global Palliative Nursing: Caring for Selected Underserved Populations in the United States
This article presents 4 examples of individuals from diverse and potentially vulnerable US populations who face unique challenges as they deal with their life-limiting diseases and face end of life. (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Online-Only Article Source Type: research

Buprenorphine Use in Palliative Care
This article uses a case example to highlight the management of substance use disorder and pain in a patient on buprenorphine along the full illness trajectory. In addition, an overview of buprenorphine pharmacology, unique aspects of the prescribing waiver, and pain management will be discussed. (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Online End-of-Life Nursing Education Consortium Core Curriculum for Staff Nurses: An Education Strategy to Improve Clinical Practice
Because of the growing population of patients with serious illness, the demand for specialty palliative care exceeds the resources available. Nurses must be prepared to provide primary palliative care to fill the gap in the availability of specialized palliative care providers. However, meeting the educational needs of a vast number of practicing nurses poses a significant challenge. Often, institutions are limited in the financial and staffing support that they can contribute for continuing nursing education, especially when the training requires staff to spend substantial time away from work. In order to address this iss...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Older Adults’ Perspectives of End of Life After the Death of a Significant Other: A Secondary Analysis
This study’s findings imply that nurses, with medical providers, should openly discuss with older adults their end-of-life concerns and care desired. Clinicians should receive education such as the COMFORT conversation and End-of-Life Nursing Education Consortium courses. Further research should explore whether older adults may be more encouraged to formulate advance directives after the death of significant others and end-of-life issues in retirement communities. Increasing public awareness of palliative and hospice services is needed. (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Advance Care Planning in Home Health: A Review of the Literature
The purpose of this article is to synthesize the evidence on advance care planning (ACP), determine what is applicable to the home health (HH) setting, and find where gaps in knowledge may exist. An integrative review methodology was chosen. Although there is ample literature on the topic of ACP, most research has been conducted in the acute care, outpatient, and general community settings. There is limited literature regarding ACP with patients living with chronic cardiovascular and pulmonary illnesses, who comprise the majority of the HH population. Some literature has been published regarding the interprofessional team&...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Developing, Promoting, and Sustaining Palliative Care Across Central Eastern Europe: Educating Nurses to Be Leaders Is a Critical First Step
Worldwide, health care is becoming more complex and multifaceted. Nurses, who spend more time at the bedside or out in the community with patients and their families than any other health care professional, need leadership-building skills in order to navigate these challenging times. New guidelines focus on interprofessional and holistic care, emphasizing the importance of building leadership skills and abilities. The World Health Organization and the European Association for Palliative Care have shown interest in influencing the development and implementation of palliative care services globally, given the increasingly ag...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

TakingAIM: A Precision Health Framework for Promoting Person-Centered Advance Care Planning
Discussions to Promote ACP (TakingAIM) model promotes population segmentation by integrating social marketing theory and the marketing mix into conceptual definitions within the context of ACP: plan (product), perception (price), preference (promotion), and pathway (place). The transtheoretical model of behavior change further guides ACP conversations at the individual level. Identifying at-risk groups and targeting their specific needs may improve the rates of advance care plans. This framework is appropriate for use in any clinical setting and is ready for empirical testing. (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Transforming Nursing Students’ Attitudes Toward End-of-Life Care
End-of-life care is an important nursing competency and must be incorporated into the baccalaureate nursing curriculum. The purpose of this research was to examine the outcomes of an actual hospice compared with a simulated hospice clinical experience. This pretest and posttest nonequivalent 2-group design consisted of a sample of 65 undergraduate nursing students enrolled in a community health course. All students enrolled in the community health course have 1 day for hospice experience and a 2-hour orientation from the nurse educator at a local hospice agency. Students enrolled in the first 7 weeks were paired with a hos...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Short-Stay Palliative Pain Management for Southwestern VA: Process Improvement Plan
The increased demand for palliative care services has led to concerns surrounding workforce knowledge and resiliency, specifically with regard to palliative pain management for patients with life-limiting illnesses. Educational preparedness of nurses along with best processes and practices is necessary to promote optimal care for patients requiring palliative pain management. Through analyzing Veterans Administration Strategic Analytics for Improvement and Learning data, a deficiency in short-stay self-reported palliative patient pain management at the Southwestern Veterans Administration Medical Center, a level 1B, tertia...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Live Discharge From Hospice: A Systematic Review
Live discharges from hospice may occur because of patient choice or provider choice. However, when discharges occur before death, patients and families may feel abandoned and left to manage care needs previously provided by hospice. The purpose of this systematic review was to better understand the nature of live discharges, including frequency, patient characteristics, and hospice characteristics. Of 44 studies identified for review, 13 met inclusion criteria and were published between 2008 and 2018. Live discharge rates varied from 5% to 23%. Patients’ prehospice characteristics varied widely based on diagnosis, co...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Pilot Implementation of a Low-Literacy Zone Tool for Heart Failure Self-management
Heart failure affects 6.5 million Americans, with 1 million hospitalizations annually, a 22% readmission rate, and $31 billion in health care costs. Palliative care decreases symptom burden, readmissions, and costs. Many elderly patients have difficulty recognizing and reporting heart failure symptoms to their providers in a timely manner. Self-management tools with color-coded zones (green = “all clear,” yellow = “caution,” red = “take action”) help patients recognize and respond to heart failure symptoms and reduce readmissions. The purpose of this quality improvement project was to de...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Symptom Management Series Source Type: research

Silent Illumination: A Case Study Exploring the Spiritual Needs of a Transgender-Identified Elder Receiving Hospice Care
This article presents a case study of a hospice volunteer who used skillful means as an artist to help a transgender-identified woman express her spirituality in the last 6 months of her life. After data analysis, 4 themes emerged related to the expression of spirituality by lesbian, gay, bisexual, transgender, and queer (LGBTQ) elders at end of life. The themes that emerged included (1) the human element in advocacy for spiritual care, (2) the importance of safe spaces for reflection and meditation, (3) the importance of skillful means to work with LGBTQ people, and (4) acknowledgement of gender identity as a spiritual ne...
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: Ethics Series Source Type: research

Association News
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: DEPARTMENTS: Association News Source Type: research

From the Editor
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - November 4, 2019 Category: Nursing Tags: DEPARTMENTS: From the Editor Source Type: research

Resilience in Koreans With Cancer: Scoping Review
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: DEPARTMENTS: CE Tests Source Type: research

Culturally Acceptable Advance Care Planning and Advance Directives for Persons Experiencing Homelessness
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: DEPARTMENTS: CE Tests Source Type: research

Undergraduate Nursing Students’ Perception of End-of-Life Care Education Placement in the Nursing Curriculum
This study used a mixed methods strategy to evaluate students’ opinions on the placement of end-of-life care education within the curriculum and their experience of having received ELNEC training previously throughout their program. Senior-level nursing student opinions on the placement of the ELNEC modules within the curriculum were equally divided, with one-third suggesting placement at the sophomore level, one-third suggesting placement at the junior level, and one-third suggesting placement at the senior level. Students also offered a recommendation for an end-of-life care simulation integration into the Bachelor...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Online-Only Articles Source Type: research

Work Satisfaction Among Hospice and Palliative Nurses
This article reports the results of a nationwide survey of 633 hospice and palliative nurses evaluating job satisfaction, intent to leave, job stressors, suggested work improvements, and self-care strategies. Statistically significant correlations were found between the Home Healthcare Job Satisfaction Scale and subscales and the individual’s self-rating of overall job satisfaction, likelihood of leaving the job, and thoughts of quitting. Multiple regression revealed a significant positive association between salary and overall job satisfaction, relationship with the organization, professional pride, autonomy, and co...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Online-Only Articles Source Type: research

Validation of a Korean Version of the Spiritual Care Competence Scale: Focused on the Hospice and Palliative Care Setting
This study aimed to examine the reliability and validity of a scale to assess the competence of Korean nurses who provide spiritual care for patients with terminal illnesses. The reliability and validity were examined using Cronbach α, item analysis, and exploratory factor analysis. The participants were 248 hospice nurses working at 40 hospices and palliative hospitals in South Korea. The results showed that the reliability was high, as indicated by a Cronbach α of .942. The exploratory factor analysis revealed 6 dimensions (assessment and implementation of spiritual care, professionalization and improvement o...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Facilitating Timely Advance Care Planning: Discussions in the Ambulatory Setting With a Heart Failure Population
This quality improvement project utilized a risk stratification process and an advance care planning (ACP) tool to identify patients at high risk of death and prompt ACP discussions and documentation of health care preferences in the electronic health record. Inherent uncertainty in heart failure (HF) prognostication and provider time constraints impede initiation of timely ACP discussions. In an effort to mitigate these obstacles, the Seattle Heart Failure Model was utilized to calculate mortality risk for 195 patients in an ambulatory HF clinic. Next, a HF-specific ACP tool, developed for this project, was used to prompt...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

The Experiences of Family Caregivers at the End of Life: Suffering, Compassion Satisfaction and Support of Health Care Professionals: Experiences of Caregivers at the End of Life
The objective of this study was to identify, through the firsthand experiences and insights of family caregivers, the key elements related to the care offered to patients with a terminal illness at the end of life. This multicenter qualitative study was based on the paradigm of hermeneutic phenomenology. Participants were relatives of patients with terminal illness who had been identified as primary caregivers. Five discussion groups and 41 in-depth interviews were organized with a total of 81 participants. The content of the interviews was analyzed based on the methods developed by Giorgi (J Phenom Psychol 1997;28(2):235-...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Evaluating the Pharmacological Management of Terminal Delirium in Imminently Dying Patients With and Without the Comfort Measure Order Set
Terminal delirium is a distressing irreversible process that occurs frequently in the dying phase, often misdiagnosed and undertreated. A previous study in our organization revealed that terminal delirium was a poorly managed symptom at end of life. Pharmacological options are available in an existing order set to manage this symptom. The management plans of 41 patients identified as having terminal delirium were further evaluated. Elements extracted included medications prescribed to manage terminal delirium, whether medication changes occurred, and whether they were administered and effective. Patients with the order set...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Rise Above: Experiences of Spirituality Among Family Caregivers Caring for Their Dying Family Member in a Hospice Setting in Pakistan
Family caregivers experience multiple transitions, resolutions, loss, and grief where their search for meaning becomes evident. Spirituality is an important dimension of palliative care, yet little attention has been given to this important aspect of spirituality especially among the family caregivers in a hospice setting. The study aimed to bring the hidden voices of family caregivers, their own spiritual experiences caring for their dying patients in a hospice setting, to guide and direct the care practices of health care professionals. An interpretive descriptive approach guided the study using a purposive sample of 18 ...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Family Caregivers’ Satisfaction With Specialized End-of-Life Care Provided at Home: Assessment of the Psychometric Characteristics of the Icelandic Version of the Family Assessment of Treatment at the End of Life Questionnaire
This study was conducted to investigate family caregivers’ assessment of specialized end-of-life care in a sample of 119 close family members in Iceland. The response rate was 58.8% (n = 70). Furthermore, the aim was to assess the psychometric characteristics of the Icelandic version of Family Assessment of Treatment at the End of Life (FATE). Descriptive statistics were used to describe the characteristics of the data. Results indicate that good communication and understanding of all parties concerned are the foundation for family caregivers’ satisfaction with end-of-life care. Participants were generally sati...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Palliative Care Nursing Competence of Chinese Oncology Nurses and Its Related Factors
In China, the development of palliative care is challenging because of limited available resources and rapidly increasing demands. The nurses’ competence is a significant element in providing high-quality palliative care. This cross-sectional study aimed to describe the palliative care competence among oncology nurses and to examine the relationships between it and palliative care knowledge, attitudes, and workplace learning conditions. A total of 220 nurses with more than 6 months of experience and who worked in inpatient wards were invited to participate in this study. Four questionnaires were administered to colle...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

End-of-Life Travel: A Bucket List Desire for Patients With Life-Limiting Illnesses
This article primarily focuses on the recommendation of medical travel as a goals-of-care comfort measure for the palliative care patient. (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Guiding the Process of Dying: The Personal Impact on Nurses
Some of the most ethically challenging and emotionally demanding aspects of nursing occur in caring for patients and their family at the end of life. The aims of this study were to examine the views of acute care nurses caring for patients during transition to comfort care, to describe the personal impact on nurses, and to identify nurses’ strategies for self-support and development of competence. Using a qualitative descriptive approach, we analyzed data from 26 semistructured interviews. Nurses experienced moral distress in situations of continuing treatment when a cure was unlikely. In managing symptoms for patie...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Integrating the Comfort Theory™ Into Pediatric Primary Palliative Care to Improve Access to Care
This article describes the application of a nursing theory framework for an evidence-based practice/quality improvement project that embedded pediatric primary palliative care into a hospital-based setting using unit-specific projects. An evidence-based practice/quality improvement project, guided by the Comfort Theory™, provided primary palliative care education and mentorship to improve knowledge, skills, and attitudes of direct care clinicians. Training consisted of didactic and self-directed learning, mentoring, and completion of unit-based projects to establish meaning and impact best practices and policies. A t...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Assessment of Primary Palliative Care Content Within Prelicensure Nursing Education: A Multisite Feasibility Study
Primary palliative care education should be provided within prelicensure programs to maximize nurses’ preparation to care for patients with serious, life-limiting illness before entering professional practice settings. Curricula need to be assessed to identify current content integration across nursing programs. The specific aim of this feasibility study was to evaluate the effectiveness of a survey methodology to assess primary palliative care content integration within prelicensure nursing curricula in multiple programs. A secondary aim was to compare content integration across nursing programs. Faculty teaching in...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

State Legislation to Prevent Diversion of Opioids in Hospice Programs: A Deeper Look Into Ohio Law
The problem of opioid diversion and its contribution to the opioid epidemic are well known nationally, existing even within hospice care. Proper disposal of opioids may be a critical factor in reducing diversion. In 2014, Ohio implemented legislation requiring a hospice employee to destroy or witness disposal of all unused opioids within a patient’s plan of care. The purpose of this study was to determine the impact of Ohio Revised Code 3712.062 on hospice programs’ policies and procedures to prevent opioid diversion in the home. Directors of Ohio-licensed hospices were surveyed to assess the percentage of prog...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Resilience in Koreans With Cancer: Scoping Review
Cancer is a major cause of mortality and morbidity in Korea. However, there has been no previous nursing literature review on the phenomenon of resilience among cancer patients in Korea. The purpose of this study was to identify information about theories, instruments, correlates, and outcomes of resilience in the cancer experiences of Korean adults. This was a scoping review that searched Ovid MEDLINE, CINAHL, Google Scholar, DBpia, and the Korean Studies Information Service System between 2000 and 2016 in order to identify English and Korean research reports. The review yielded 17 quantitative studies, including 2 resili...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Global Exemplar Series Source Type: research

Culturally Acceptable Advance Care Planning and Advance Directives for Persons Experiencing Homelessness
This study addressed this knowledge gap, and its findings serve as the basis for developing additional strategies to promote a satisfying ACP experience for this population when they complete an AD. The purpose of this study was to discover if an AD form recreated for PEHs would positively affect their completion of the AD as well as their overall experience with ACP. Guided by the culture care theory and qualitative ethnonursing methodology, 38 individuals (30 PEHs and 8 student nurses) were interviewed. Data were analyzed using the 4 phases of ethnonursing analysis. The 3 themes abstracted were (1) “it needs to be ...
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: Ethics Series Source Type: research

Association News
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: DEPARTMENTS: Association News Source Type: research

From the Editor
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - September 6, 2019 Category: Nursing Tags: DEPARTMENTS: From the Editor Source Type: research

Kennedy Terminal Ulcers: A Scoping Review
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: DEPARTMENTS: CE Tests Source Type: research

Emotional Intelligence in Neonatal Intensive Care Unit Nurses: Decreasing Moral Distress in End-of-Life Care and Laying a Foundation for Improved Outcomes: An Integrative Review
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: DEPARTMENTS: CE Tests Source Type: research

Medication Safety in Hospice and Palliative Care Settings
No abstract available (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: DEPARTMENTS: HPNA Position Statement Source Type: research

HPNA 2019-2022 Research Agenda: Development and Rationale
Building on the strong work of previous research agendas (2009-2012, 2012-2015, 2015-2018), the Hospice and Palliative Nurses Association Research Advisory Council developed the 2019-2022 Research Agenda in consultation with Hospice and Palliative Nurses Association (HPNA) membership and assessment of major trends in palliative nursing. The HPNA Research Advisory Council identified 5 priority areas and asked subject experts in each area to summarize the state of the science, identify critical gaps, and provide recommendations for future research. This document expands the executive summary published on the HPNA website (ww...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Online-Only Article Source Type: research

The Korean–Advance Directive Model and Factors Associated With Its Completion Among Patients With Hematologic Disorders
The objective of this pilot study was to examine factors associated with the completion of advance directives (ADs) among patients with hematologic disorders in Korea. Using a descriptive design, patients with largely hematologic malignancies completed the questionnaires, including the Korean–Advance Directive (K-AD) model, which pertains to values, treatment wishes, and proxy appointment. Of 45 patients (aged 48.7 ± 10.7 years, 51.1% men), two-thirds had leukemia (40.0%) and lymphoma (26.7%). “Dying comfortably” was the most frequently selected value (n = 20). Regarding treatment wishes, hospice c...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Global Exemplar Series Source Type: research

Developing a Measure of End-of-Life Care Nursing Knowledge for Japanese Geriatric Nurses
This study developed an end-of-life (EOL) care nursing knowledge scale for Japanese geriatric nurses (ELNKS-JG) to measure nurse knowledge of EOL care for older adults. It also was used to evaluate the quality of The End-of-Life Nursing Education Consortium–Japan Geriatric. Participants were 1168 nurses employed in 32 institutions across Japan. The items of our measure were developed to cover 8 important topics: principles of EOL care for older adults; pain management; symptom management; ethics of care; cultural and spiritual considerations; communication; loss, grief, and bereavement; and caring for final days. The...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Online-Only Article Source Type: research

Parents’ Wishes for What They Had or Had Not Done and Their Coping After Their Infant’s or Child’s Neonatal Intensive Care Unit/Pediatric Intensive Care Unit/Emergency Department Death
This qualitative study asked 70 mothers and 26 fathers 3 open-ended questions on what they wish they had and had not done and on coping 2, 4, 6, and 13 months after their infant’s/child’s neonatal intensive care unit/pediatric intensive care unit/emergency department death. Mothers wished they spent more time with the child, chosen different treatments, advocated for care changes, and allowed the child his or her wishes. Fathers wished they had spent more time with the child and gotten care earlier. Mothers wished they had not agreed to child’s surgery/treatment, taken her own actions (self-blame), and le...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Opting Out of a Time-of-Death Visit: Insights From Home Hospice Family Members
Hospice patients die in various settings, including at home with family caregivers. Hospice offers a time-of-death visit to provide support and confirm death, a requirement in some states but not all. Few studies have been conducted among home hospice families exploring their experiences without a time-of-death visit. To better understand the family’s experience regarding the time of death of their loved one, we conducted an exploratory study using a hermeneutic phenomenological approach. Home hospice families who had experienced a death within the last 6 to 13 months and had not received a time-of-death visit were r...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Interdisciplinary Perspectives on the Value of Massage Therapy in a Pediatric Hospice
This study aimed to explore clinicians’ perspectives on the value of providing massage therapy to support children in hospice care, their families, and staff. The research participants (n = 6) comprised Canuck Place clinicians who have experience with the massage therapy practicum. In this descriptive phenomenological inquiry, semistructured interviews and thematic analysis were used. The findings demonstrated that Canuck Place clinicians valued the massage therapy practicum for its practical support in terms of creating access to massage therapy and self-care in the hospice. Massage therapy was also valued for suppo...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Nurses’ Perspectives on Family Caregiver Medication Management Support and Deprescribing
Nurses who care for patients with life-limiting illness operate at the interface of family caregivers (FCGs), patients, and prescribers and are uniquely positioned to guide late-life medication management, including challenging discussions about deprescribing. The study objective was to describe nurses’ perspectives about their role in hospice FCG medication management. Content analysis was used to analyze qualitative interviews with nurses from a parent study exploring views on medication management and deprescribing for advanced cancer patients. Ten home and inpatient hospice nurses, drawn from 3 hospice agencies a...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Face-to-Face Documentation Using the FACE-2-FACE Method
Nurse practitioners play an integral part of the face-to-face visit. The face-to-face visit requirement came into effect on January 11, 2011, for hospice patients entering their third or later benefit period. The face-to-face requirement was created because of concerns regarding high numbers of hospice patients with lengths of stay greater than 180 days, in addition to concerns the physician was not as active in the care of the hospice patient as required. Face-to-face visits can be completed by the hospice physician or nurse practitioner employed by the hospice agency. The face-to-face narrative includes a clear title, da...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research

Accuracy of the Surprise Question on an Inpatient Oncology Service: A Multidisciplinary Perspective
The surprise question (SQ), “Would you be surprised if your patient died within a year?”, has been studied in the cancer population as a prognostic prompt. Studies have almost exclusively directed the SQ to physicians, whereas perspectives of nurses remain underevaluated. We asked the SQ for patients admitted to an inpatient medical oncology service to medical oncology, palliative care, and hospital medicine teams and bedside nurses. We performed a 1-year retrospective chart review to identify how concordant various provider types were in their prognostic estimations and identified the missed opportunity rate (...
Source: Journal of Hospice and Palliative Nursing - July 4, 2019 Category: Nursing Tags: Feature Articles Source Type: research