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https://www.readbyqxmd.com/read/28333571/screening-and-assessment-of-substance-use-in-hospice-care-examining-content-from-a-national-sample-of-psychosocial-assessments
#1
Paul Sacco, John G Cagle, Melissa L Moreland, Elizabeth A S Camlin
BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers...
March 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28330507/is-admittance-to-specialised-palliative-care-among-cancer-patients-related-to-sex-age-and-cancer-diagnosis-a-nation-wide-study-from-the-danish-palliative-care-database-dpd
#2
Mathilde Adsersen, Lau Caspar Thygesen, Anders Bonde Jensen, Mette Asbjoern Neergaard, Per Sjøgren, Mogens Groenvold
BACKGROUND: Specialised palliative care (SPC) takes place in specialised services for patients with complex symptoms and problems. Little is known about what determines the admission of patients to SPC and whether there are differences in relation to institution type. The aims of the study were to investigate whether cancer patients' admittance to SPC in Denmark varied in relation to sex, age and diagnosis, and whether the patterns differed by type of institution (hospital-based palliative care team/unit, hospice, or both)...
March 23, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28329822/it-s-all-about-the-relationship-cognitively-intact-mother-daughter-care-dyads-in-hospice-at-home
#3
Diane N Solomon, Lissi Hansen, Judith G Baggs
Purpose of the Study: Adult daughters providing care to aging, ill mothers comprise the most prevalent caregiving dyad. Little is known, however, regarding relationship quality and its impact on care in these dyads, particularly in the context of cognitively intact patients at end of life in hospice. This interpretive descriptive work privileges voices of terminally ill mothers and care-partnering daughters in the home hospice context. Specific aims were to describe and interpret how mothers and daughters: (a) perceive relationship quality and (b) perceive how relationships have developed over time through health, chronic illness, and hospice...
March 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28328647/pressure-injury-in-a-community-population-a-descriptive-study
#4
Lisa Q Corbett, Marjorie Funk, Gilbert Fortunato, David M OʼSullivan
PURPOSE: The purpose of this study was to describe present-on-admission pressure injuries (POA-PIs) in community-dwelling adults admitted to acute care. The specific aims of the study were to (1) measure the prevalence of POA-PIs during a 1-year period; (2) determine prehospital location of patients with POA-PIs; and (3) describe demographics, pressure injury (PI) characteristics, risk factors, and posthospital outcome of community-dwelling adults with PIs admitted to hospital. DESIGN: Retrospective descriptive study...
March 21, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28325240/cancer-care-access-and-outcomes-for-american-indian-populations-in-the-united-states-challenges-and-models-for-progress
#5
REVIEW
B Ashleigh Guadagnolo, Daniel G Petereit, C Norman Coleman
Low socioeconomic and health care access realities of being American Indian/Alaskan Native (AI/AN) in the United States combined with decades of data documenting poor cancer outcomes for this population provide a population nested within the United States that is analogous to the cancer care landscape of low- and middle-income countries internationally. We reviewed the medical literature with respect to cancer prevention, access to cancer treatment, and access to effective supportive and palliative care for AI/AN populations in the United States...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28323079/factors-driving-live-discharge-from-hospice-provider-perspectives
#6
Rachel Dolin, Laura C Hanson, Sarah Rosenblum, Sally Stearns, Mark Holmes, Pam Silberman
CONTEXT: The proportion of patients disenrolling from hospice prior to death has increased over the decade with significant variations across hospice types and regions. Such trends have raised concerns about live disenrollment's effect on care quality. Live disenrollment may be driven by factors other than patient preference and may create discontinuities in care, disrupting ongoing patient-provider relationships. Researchers have not explored when and how providers make this decision with patients...
March 16, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28321300/identifying-highlighting-and-reducing-polypharmacy-in-a-uk-hospice-inpatient-unit-using-improvement-science-methods
#7
Alison Phippen, Jennie Pickard, Douglas Steinke, Matt Cope, Dai Roberts
Polypharmacy, the concurrent use of multiple medications by one individual is a growing global issue driven by an ageing population and increasing prevalence of multi-morbidity[1]. Polypharmacy can be problematic: interactions between medications, reduced adherence to medication, burden of medication to patients, administration time, increased risk of errors and increased cost. Quality improvement methods were applied to identify and highlight polypharmacy patients with the aim of reducing their average number of regular tablets/capsules per day by 25%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28319583/factor-structure-of-the-cultural-competence-items-in-the-national-home-and-hospice-care-survey
#8
Azza AbuDagga, Constance A Mara, Adam C Carle, Robert Weech-Maldonado
BACKGROUND: There is a need for validated measures of cultural competency practices in home health and hospice care (HHHC). OBJECTIVE: To establish the factor structure of the cultural competency items included in the agency-component of the 2007 public-use National Home and Hospice Care Survey file. DATA SOURCE: We used weighted survey data from 1036 HHHC agencies. RESEARCH DESIGN AND PARTICIPANTS: We used exploratory factor analyses to identify a preliminary factor structure, and then performed confirmatory factor analysis to provide further support for identified factor structure...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28316930/transudative-pleural-effusion-of-malignant-etiology-rare-but-real
#9
Lindsey Johnson, Hafiz Abdul Moiz Fakih, Salim Daouk, Shaheera Saleem, Ali Ataya
A 62-year-old female presented to the emergency room with one-month history of epigastric abdominal pain, nausea and vomiting. She endorsed progressive dyspnea over two weeks. CT of the abdomen demonstrated bilateral pleural effusions and pancreatic inflammation, so the working diagnosis was pancreatitis. A diagnostic thoracentesis was performed and the pleural fluid analysis was classified as transudate by Light's criteria. Given the atypical features in history and concern for malignancy, fluid was sent for cytological examination and immunohistochemistry which suggested a mucinous malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28306661/referring-patients-to-hospice-or-palliative-care
#10
Kathleen Broglio, Anne Walsh
NPs care for patients with chronic diseases such as heart failure, chronic obstructive pulmonary disease, cancer, and dementia. As the disease progresses or patients age, disease-related symptoms may become increasingly burdensome, and these patients may benefit from hospice or palliative care. NPs can guide individuals in this process to optimize care and support at the end of life.
April 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28306372/standardized-criteria-for-palliative-care-consultation-on-a-solid-tumor-oncology-service-reduces-downstream-health-care-use
#11
Kerin Adelson, Julia Paris, Jay R Horton, Lorena Hernandez-Tellez, Doran Ricks, R Sean Morrison, Cardinale B Smith
PURPOSE: Hospitalized patients with advanced cancer have a high symptom burden and need for support. Integration of palliative care (PC) improves symptom control and decreases unwanted health care use, yet many patients are never offered these services. In 2016, ASCO called for incorporation of PC into oncologic care for all patients with metastatic cancer. To improve the quality of cancer care, we developed standardized criteria, or triggers, for PC consultation on the inpatient solid tumor service...
March 17, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28301894/transitions-in-care-for-infants-with-trisomy-13-or-18
#12
Jacquelyn Patterson, Genevieve Taylor, Melissa Smith, Sarah Dotters-Katz, Arlene M Davis, Wayne Price
Background and Objectives The scope of interventions offered to infants with trisomy 13 (T13) or trisomy 18 (T18) is increasing. We describe the spectrum of care provided, highlighting transitions in care for individual patients. Patients and Methods This is a single-center, retrospective cohort of infants with T13 or T18 born between 2004 and 2015. Initial care was classified as comfort care or intervention using prenatal counseling notes. Transitions in care were identified in the medical record. Results In this study, 25 infants were divided into two groups based on their care: neonates who experienced no transition in care and neonates who experienced at least one transition...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28296604/lessons-from-oregon-in-embracing-complexity-in-end-of-life-care
#13
Susan W Tolle, Joan M Teno
Under the incentives of fee-for-service Medicare, the utilization trends among persons with chronic progressive medical illness include more care in the intensive care unit (ICU), more hospitalizations, and often late or no referrals to hospice care (Figure 1). These utilization patterns are..
March 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28296534/trends-of-do-not-resuscitate-orders-hospice-care-utilization-and-late-referral-to-hospice-care-among-cancer-decedents-in-a-tertiary-hospital-in-taiwan-between-2008-and-2014-a-hospital-based-observational-study
#14
Tzu-Chien Shih, Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Tzeng-Ji Chen, Shinn-Jang Hwang
BACKGROUND: Out of respect for terminal patients' dignity and to decrease end-of-life suffering, patients in Taiwan can choose to sign do-not-resuscitate (DNR) orders and use hospice care when they are in a terminal condition. OBJECTIVES: To explore the trends and characteristics of hospice care utilization and DNR status among terminal cancer patients. Design and Setting/Subjects: A secondary data analysis was conducted to examine the rate of DNR orders, hospice care utilization, the survival time after DNR order, the duration of survival (DOS) after hospice care enrollment, and the rate of late referral to hospice care among patients who died from malignant cancers in a tertiary hospital in Taiwan between 2008 and 2014...
March 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28295145/variation-in-hospice-services-by-location-of-care-nursing-home-versus-assisted-living-facility-versus-home
#15
Kathleen T Unroe, Brittany Bernard, Timothy E Stump, Wanzhu Tu, Christopher M Callahan
OBJECTIVES: To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. DESIGN: Retrospective cohort study using hospice patient electronic medical record data. SETTING: Large, national hospice provider. PARTICIPANTS: Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed...
March 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28295138/frequency-and-risk-factors-for-live-discharge-from-hospice
#16
David Russell, Eli L Diamond, Bonnie Lauder, Ritchell R Dignam, Dawn W Dowding, Timothy R Peng, Holly G Prigerson, Kathryn H Bowles
OBJECTIVES: To report frequencies and associated risk factors for 4 distinct causes of live discharge from hospice. DESIGN: Retrospective cohort study using electronic medical records of hospice patients who received care from a large urban not-for-profit hospice agency in New York City during a 3-year period between 2013 and 2015 (n = 9,190). RESULTS: Roughly one in five hospice patients were discharged alive (21%; n = 1911). Acute hospitalization was the most frequent reason for live discharge (42% of all live discharges; n = 802)...
March 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28292824/hospice-enrollment-in-patients-with-advanced-heart-failure-decreases-acute-medical-service-utilization
#17
Cindi K Yim, Yolanda Barrón, Stanley Moore, Chris Murtaugh, Anuradha Lala, Melissa Aldridge, Nathan Goldstein, Laura P Gelfman
BACKGROUND: Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. METHODS AND RESULTS: We performed a descriptive analysis of Medicare fee-for-service beneficiaries, with at least one home health claim between July 1, 2009, and June 30, 2010, and at least 2 HF hospitalizations between July 1, 2009, and December 31, 2009, who subsequently enrolled in hospice between July 1, 2009, and December 31, 2009...
March 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28292566/impact-of-anticoagulation-in-elderly-patients-with-pulmonary-embolism-that-undergo-ivc-filter-placement-a-retrospective-cohort-study
#18
John M Falatko, Bhavinkumar Dalal, Lihua Qu
BACKGROUND: Anticoagulation is the primary treatment for pulmonary embolism (PE). Inferior vena cava (IVC) filters are an adjunctive intervention to prevent recurrent pulmonary embolism. Long-term outcomes in elderly patients with contraindications to anticoagulation after IVC filter placement for prevention of recurrent pulmonary embolism have yet to be assessed. MATERIALS AND METHODS: Patients ≥60years of age, that had an IVC filter placed between January 1st, 2008 and February 2nd, 2013, with a primary diagnosis of pulmonary embolism, were included...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28288954/content-usability-and-utilization-of-plain-language-in-breast-cancer-mobile-phone-apps-a-systematic-analysis
#19
Tamar Ginossar, Sayyed Fawad Ali Shah, Andrew J West, Joshua M Bentley, Charlene A Caburnay, Matthew W Kreuter, Anita Y Kinney
BACKGROUND: Breast cancer is one of the leading contributors to preventable illness and death among women. Although mobile phone apps provide unprecedented opportunity to engage women along the cancer continuum, little is known about the availability, content, and usability of breast cancer mobile phone apps. OBJECTIVE: This study analyzed the content and adherence to literate design standards of all breast cancer-related apps available on the App Store and Google Play, as well as the relationship between their content, user ratings, and price...
March 13, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28287363/nebulized-fentanyl-for-dyspnea-in-a-hospice-patient-with-true-allergy-to-morphine-and-hydromorphone
#20
Robert G Wahler, David B Smith, Kimberly B Mulcahy
An 86-year-old white female was admitted to hospice care with lung cancer. Even with optimal medical management, she suffered from dyspnea and required opioid therapy. However, the patient had a true morphine and hydromorphone allergy. She was administered nebulized fentanyl for symptomatic relief of dyspnea with good effect and she did not experience any allergic response.
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
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