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Blog -- APRN Quality Improvement Project
Blog: Provider-Associated Barriers to Hospice Referrals
The process of writing the quality improvement project for improving hospice referrals for patients suffering from end-stage dementia care was very instructive. Reading the relevant literature revealed which research questions in dementia care are considered important by scientists and care professionals and which questions have yet to be asked. Aside from helping to outline appropriate goals for the quality improvement project, this task revealed that end-stage dementia care is a relatively understudied area of medicine. Writing the literature review also uncovered a list of best practice recommendations for palliative care, in relation to dementia, which was previously unknown to me. Overall, writing the quality improvement project helped me collect best practice recommendations authored by dementia care experts and understand the state of research in palliative care for patients suffering from end-stage dementia. This in turn increased my proficiency as a nurse working in palliative medicine.
Writing the methods section for the quality improvement project forced me to think about the most important preventable barriers affecting timely and appropriate hospice referrals for this patient population, which led me to provider-associated barriers. As I scoured the literature...
This task forced me to consider my own role as a nurse working in palliative medicine and how I can contribute to the timely and appropriate provision of hospice referrals for this patient population, thereby increasing my competency.
The main barrier encountered when planning and developing this quality improvement project was the lack of published instruments, such as questionnaires and surveys, which could be used to analyze provider-associated barriers to timely hospice referrals. Luckily, a team of researchers and clinicians developed a questionnaire (Snyder, Hazelett, Allen, & Radwany, 2013) that had the potential to fill this need, once it was adapted to the specific goals of this project. Another major barrier was the difficulty of determining an accurate prognosis for patients suffering from end-stage dementia, with the best instrument developed so far producing only moderate accuracy (Mitchell et al., 2010). Despite this limitation, the provider education packet included this instrument. Currently, the adapted questionnaire has been sent to participating providers and 11 have been returned in order to…
References
Mitchell, S.L., Miller, S.C., Teno, J.M., Davis, R.B., & Shaffer, M.L. (2010). The Advanced Dementia Prognostic Tool: A risk score to estimate survival in nursing home residents with advanced dementia. Journal of Pain and Symptom Management, 40(5), 639-51. Doi: 10.1016/j.jpainsymman.2010.02.014.
Snyder, S., Hazelett, S., Allen, K., & Radwany, S. (2013). Physician knowledge, attitude, and experience with advance care planning, palliative care, and hospice: Results of a primary care survey. American Journal of Hospice & Palliative Care, 30(5), 419-24. Doi: 10.1177/1049909112452467.
Family Communication There is a lot of information on dementia, and even a lot about the concerns that families may have about the treatment of their loved ones in facilities, however there is very little if not any research regarding communication between dementia patients and their families before and after placement in a long-term care facility. Clark, Bass, Looman, McCathy, & Eckert (2004), reported that while various quantitative and qualitative analyses have
As the number of dementia patients with end-stage illness is increasing; a higher number of social workers will be required to treat them in the future. It is important to evaluate the behavioral patterns of social workers dealing with such patients. The main purpose of such research is to identify the possible causes for such behavior so that necessary measures can be taken to reverse the situation. Role of Hospice
Hisory of Palliatve Care Palliative Care Palliative Care Methods Palliative care entails assisting patients get through pain caused by different diseases. The patient may be ailing from any diseases, be it curable or untreatable. Even patient who are sick and almost passing away will need this care. Palliative care has characteristics that differentiate it to hospice care. The key role for palliative care is to help in improving the existence of someone and
Adult Day Care Industry Analysis Adult day care centers are non-residential facilities that provide and support the health, nutrition and social needs of adults. They are usually staffed with professionals and the adults are kept in groups to provide meaningful activities and ensure ease of socializing and supervision. In some adult day care services, medical services such as assessment, rehabilitation and treatment may be conducted to ensure that chronic conditions such
Nursing Tasks, Methods, And Expectations State of the Industry The Art and Science of Nursing Relative Pay Scales Male Nursing Roles Sex Stereotypes The Influence of the Nationalized Healthcare Debate Proposed Methods toward Recruiting Nurses Joint Corporate Campaigns Steps to Recruiting Men Wages issues Recent employment trends in the nursing field have demonstrated a disconcerting drop in the number of employed and employable nurses. In what has been traditionally a female dominated filed, the exit rate of both men and women,
In the case of the former of these groups, there is a demand for proper training and experience in helping family members face the practical realities imposed by the death of a loved one. Further, research demonstrates that many acute care settings are lacking in the capacity to manage these particular issues, failing particularly to make some of the most basic steps needs to help the bereaved face this difficult