Sowing Across a State: Development and Delivery of a Grassroots Pediatric Palliative Care Nursing Curriculum

2019 ◽  
Vol 36 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Meaghann S. Weaver ◽  
Rebecca Jenkins ◽  
Christopher Wichman ◽  
Jacob E. Robinson ◽  
Meghan R Potthoff ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Curriculum Design ◽  
Phase 1 ◽  
Pediatric Palliative Care ◽  
Family Needs ◽  
Team Members ◽  
Curricular Content ◽  
Home Based ◽  
Perception Of Support

Background: Rural pediatricians and adult-trained hospice teams report feeling ill-prepared to care for children at end of life, resulting in geographies in which children are not able to access home-based services. Objectives: To develop a pediatric palliative care curriculum for inpatient nurses and adult-trained hospice teams caring for children in a rural region. Methods: Curriculum design and delivery was informed by local culture through an interdisciplinary, iterative development approach with confidence, intention, and support measured pre-, post-, and 4 months after delivery. A needs assessment was completed by pediatric nurses caring for children receiving palliative or end-of-life care to inform curricular content (phase 1). A curriculum was designed by an interdisciplinary pediatric palliative care team and piloted with nursing cohorts annually through educational conferences with monthly discussion series for 3 consecutive years (phase 2). Curricular content was then provided for 31 rural hospice team members (phase 3). Results: Self-reported confidence in caring for children increased by 1.1/10 points for adult-trained hospice team members. Mean score for intention to care for children increased by 5.2 points (sustained 5.1 points above baseline at 4 months). Perception of support in caring for children increased by 5 points (mean sustained 5.4 points above baseline at 4 months). Family needs, care goals, and symptom management were prioritized learning topics. Rural hospices previously unwilling to accept children enrolled pediatric patients in the 4 months following the conference. Conclusion: Grassroots curricular initiatives and ongoing educational mentorship can grow pediatric palliative and hospice services in rural regions.

Patterns of Hospice and Home-Based Palliative Care in Children: An Ohio Pediatric Palliative Care and End-of Life Network Study

2020 ◽  
Vol 225 ◽  
pp. 152-156 ◽  
Author(s):  
Daniel H. Grossoehme ◽  
Lisa Humphrey ◽  
Sarah Friebert ◽  
Lili Ding ◽  
Gang Yang ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Pediatric Palliative Care ◽  
Home Based

scholarly journals Evidence on the economic value of end-of-life and palliative care interventions: a narrative review of reviews

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xhyljeta Luta ◽  
Baptiste Ottino ◽  
Peter Hall ◽  
Joanna Bowden ◽  
Bee Wee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cost Effectiveness ◽  
End Of Life ◽  
Resource Use ◽  
Economic Value ◽  
Healthcare Delivery ◽  
Dying Patients ◽  
Home Based ◽  
Population Type ◽  
Care Models

Abstract Background As the demand for palliative care increases, more information is needed on how efficient different types of palliative care models are for providing care to dying patients and their caregivers. Evidence on the economic value of treatments and interventions is key to informing resource allocation and ultimately improving the quality and efficiency of healthcare delivery. We assessed the available evidence on the economic value of palliative and end-of-life care interventions across various settings. Methods Reviews published between 2000 and 2019 were included. We included reviews that focused on cost-effectiveness, intervention costs and/or healthcare resource use. Two reviewers extracted data independently and in duplicate from the included studies. Data on the key characteristics of the studies were extracted, including the aim of the study, design, population, type of intervention and comparator, (cost-) effectiveness resource use, main findings and conclusions. Results A total of 43 reviews were included in the analysis. Overall, most evidence on cost-effectiveness relates to home-based interventions and suggests that they offer substantial savings to the health system, including a decrease in total healthcare costs, resource use and improvement in patient and caregivers’ outcomes. The evidence of interventions delivered across other settings was generally inconsistent. Conclusions Some palliative care models may contribute to dual improvement in quality of care via lower rates of aggressive medicalization in the last phase of life accompanied by a reduction in costs. Hospital-based palliative care interventions may improve patient outcomes, healthcare utilization and costs. There is a need for greater consistency in reporting outcome measures, the informal costs of caring, and costs associated with hospice.

scholarly journals General practitioners’ perceptions of best practice care at the end of life: a qualitative study

BJGP Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. bjgpopen19X101660 ◽  
Author(s):  
Anne Herrmann ◽  
Mariko Carey ◽  
Alison Zucca ◽  
Lucy Boyd ◽  
Bernadette Roberts
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Best Practice ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Natural Extension ◽  
Family Needs ◽  
Qualitative Interview Study ◽  
Wide Range ◽  
Practice Care

BackgroundGPs can play a central role in palliative care delivery. However, little is known about their views on what constitutes best practice care at the end of life.AimTo explore, in a sample of Australian GPs, their perceptions of best practice palliative care and their ideal role in its delivery.Design & settingA qualitative interview study of 25 GPs practising in metropolitan and non-metropolitan locations in New South Wales, Australia.MethodSemi-structured telephone interviews were conducted. Data were analysed using qualitative content analysis.ResultsParticipants had a mean age of 51 years, and had practised between 3 and 38 years (mean 19 years). Best practice palliative care was perceived to be proactive and responsive to a wide range of patient and family needs. Many participants indicated a need for relational continuity, which involves GPs establishing a care pathway from diagnosis to palliation, coordinating care across the pathway, and collaborating with other healthcare providers. A number of participants perceived palliative care as a natural extension of primary care and indicated that best practice palliative care mainly requires experiential knowledge and good communication skills, rather than specialised medical knowledge. Participants listed a number of communication strategies to offer patients and their families choice and ongoing negotiation about the recommended treatments.ConclusionThis study provides novel in-depth insights into GPs’ perceptions of best practice palliative care. Future research should further investigate the identified features of care, and whether they can maximise the outcomes of patients and their families.

Pain Management

2019 ◽  
pp. 116-131
Author(s):  
Judith A. Paice
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
End Of Life ◽  
Family Communication ◽  
Pain Control ◽  
Care Program ◽  
Palliative Care Program ◽  
Institutional Policies ◽  
Team Members ◽  
Serious Illness

Pain is one of the most common and most feared symptoms experienced by those with serious illness. The nurse’s role begins with assessment and continues through the development of a plan of care and its implementation. During this process, the nurse provides education and counseling to the patient, family, and other team members. Nurses also are critical for developing institutional policies and monitoring outcomes that ensure good pain management for all patients within their palliative care program. To provide optimal pain control, all healthcare professionals must understand the frequency of pain at the end of life, the barriers that prevent good management, the comprehensive assessment of this syndrome, and the treatments used to provide relief. Effective pain control and alleviation of suffering is highly dependent upon the strength of clinician, patient, and family communication and relationship. These are key strengths of nursing, at all phases of palliative care.

End-of-Life Care in Patients Exposed to Home-Based Palliative Care vs Hospice Only

2019 ◽  
Vol 67 (6) ◽  
pp. 1226-1233 ◽  
Author(s):  
Susan E. Wang ◽  
In-Lu Amy Liu ◽  
Janet S. Lee ◽  
Peter Khang ◽  
Romina Rosen ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Home Based

scholarly journals Development of a Pediatric Palliative Care Curriculum and Dissemination Model: Education in Palliative and End-of-Life Care (EPEC) Pediatrics

2019 ◽  
Vol 58 (4) ◽  
pp. 707-720.e3 ◽  
Author(s):  
Stefan J. Friedrichsdorf ◽  
Stacy Remke ◽  
Joshua Hauser ◽  
Laurie Foster ◽  
Andrea Postier ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Pediatric Palliative Care ◽  
Life Care
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