scholarly journals Palliative Care Conversations for Heart Failure Nurses: A Pilot Education Intervention

2021 ◽  
Vol 7 ◽  
pp. 237796082110445
Author(s):  
Stephanie Turrise ◽  
Caroline A. Jenkins ◽  
Tamatha Arms ◽  
Andrea L. Jones
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Online Education ◽  
Care Delivery ◽  
Education Intervention ◽  
Effective Care ◽  
Professional Caregiver ◽  
Scale Scores ◽  
Before And After ◽  
Pilot Education

Introduction Heart failure is a progressive condition affecting 6.2 million Americans. The use of palliative and supportive care for symptom management and improved quality of life is recommended for persons with heart failure. However, 91% of nurses believe they need further training to have palliative care conversations. The purpose of this pilot education intervention was to determine if providing nurses with education on the timing and content of palliative care conversations would improve their perceived skill and knowledge. Methods This was a pilot study of an online educational intervention. Data were electronically collected from 13 participants using validated questionnaires delivered via Qualtrics. Participants completed a demographic survey and End-of-Life Professional Caregiver Survey (EPCS) before and after completing an online, asynchronous education module. Results Mean scores were higher on all posttest measures. Independent samples t-tests revealed statistically significant differences on the Effective Care Delivery (ECD) scale ( t[32] = −2, p = .05) and total EPCS scale scores ( t[32] = −2.2, p = .03) from pre- to posttest. Conclusion Scores increased on all dimensions pretest to posttest with statistically significant differences in ECD and total scores. Providing asynchronous online education on timing and content of palliative care conversations to nurses caring for people with heart failure is a feasible and effective way to improve perceived knowledge and skill of palliative care conversations.

scholarly journals P1855ONLINE PATIENT/CAREGIVER EDUCATION ON HYPERKALEMIA CAN IMPROVE KNOWLEDGE AND COMPETENCE AS WELL AS PROMPT REAL LIFE CHANGES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Amy Larkin ◽  
Don Blatherwick
Keyword(s):  
Heart Failure ◽  
Online Education ◽  
Real Life ◽  
Outcomes Analysis ◽  
High Potassium ◽  
Caregiver Education ◽  
Knowledge Question ◽  
Before And After ◽  
Strict Diet ◽  
The Impact

Abstract Background and Aims Managing hyperkalemia with a strict diet is limiting and difficult for patients. We sought to measure the impact of online education for patients/caregivers on knowledge and confidence as well as prompting change in daily life. Method The patient/caregiver education was designed as 2 online, interactive activities. Both were comprised of text and integrated visuals; the second also included a patient commentary video. Demographic questions were asked prior to starting the education. A knowledge question was asked both before and after the activity to assess learning gains, as well as intent to change and confidence questions at the end. Absolute improvements were calculated for pre/post questions. The activities launched in April and May of 2019, and data collected through October 2019. Results To date, 98,462 learners have participated in the patient/caregiver activity. Activity 1: High Potassium: Causes and reasons to Treat Participants: 60,060 Completers of all questions (included in outcomes analysis): 7,262 Demographics: 59% female; 49% white, non-Hispanic; 66% over the age of 54; 16% have hyperkalemia, 75% were interested in learning more about the condition Knowledge changes: 13% improvement in understanding what causes hyperkalemia (46% pre to 59% post) Intent-to-act: 66% plan to talk to an HCP about next steps for treating hyperkalemia Confidence changes: 82% reported increased confidence understanding why it’s important to treat hyperkalemia Activity 2: It’s Complicated: How to Manage High Potassium and Heart Failure Participants: 38,402 Completers of all questions (included in outcomes analysis): 3,816 Demographics: 60% female; 63% white, non-Hispanic; 69% over the age of 54; 58% were interested in learning more about the condition and 25% have this condition Knowledge changes: 13% improvement in recognizing how potassium levels effect the heart (76% pre to 89% post) Intent-to-act: 64% plan to talk to their healthcare provider about a plan to manage my hyperkalemia Confidence changes: 82% reported increased confidence understanding how important is it to manage my heart failure and hyperkalemia Conclusion The metrics and outcomes gathered in this assessment are a strong indicator that these patient/caregiver-focused online educational activities improved knowledge and confidence, and prompted intent to act by patients/caregivers related to hyperkalemia.

The relationship between the timing of a palliative care consult and utilization outcomes for ventilator-assisted intensive care unit patients

2013 ◽  
Vol 13 (2) ◽  
pp. 217-221 ◽  
Author(s):  
Salonie Pereira ◽  
Andrzej Kozikowski ◽  
Renee Pekmezaris ◽  
Suzanne Sunday ◽  
Tanveer Mir ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Care Delivery ◽  
Retrospective Chart Review ◽  
Improve Patient Care ◽  
Medication Costs ◽  
Number Of Patients ◽  
Before And After ◽  
The Relationship

AbstractObjective:Given the great number of chronic care patients facing the end of life and the challenges of critical care delivery, there has been emerging evidence supporting the benefit of palliative care in the intensive care unit (ICU). We studied the relationship between the timing of a palliative care consult (PCC) and two utilization outcomes — length of stay (LOS) and pharmacy costs — in ventilator-assisted ICU patients.Method:A retrospective chart review was conducted (N = 90). Summed pharmacy costs were compared using a paired t test before and after PCC. Spearman correlations were performed between days to PCC and ICU LOS, ventilator days, and days to death following ventilator discontinuation.Results:Number of days from admission to PCC was correlated with total days on ventilator (ρ = 0.685, p < 0.0001) and total ICU LOS (ρ = 0.654, p < 0.0001). Number of days to PCC was correlated with pre-PCC total medication costs (ρ = 0.539, p < 0.0001). Median medication costs were significantly reduced after the PCC (p < 0.0001), from $230.96 to 30.62. Median medication costs decreased for all categories except for analgesics, antiemetics, and opioids. The number of patients receiving opioid infusion increased (37 vs. 90%) after PCC (p < 0.0001).Significance of results:Earlier timing for PCC in the ICU is associated with a lower LOS through quicker mechanical ventilation (MV) withdrawal, presenting a unique opportunity to both decrease costs and improve patient care.

scholarly journals Interventions aimed at addressing unplanned hospital readmissions in the U.S.: A systematic review

2018 ◽  
Vol 8 (1) ◽  
pp. 16 ◽  
Author(s):  
Alva O. Ferdinand ◽  
Ohbet Cheon ◽  
Abdulaziz T. Bako ◽  
Bita A. Kash
Keyword(s):  
Heart Failure ◽  
Behavioral Interventions ◽  
Care Delivery ◽  
Hospital Readmissions ◽  
Chronic Obstructive ◽  
Healthcare Organizations ◽  
Obstructive Pulmonary Disease ◽  
Heart Failure Patients ◽  
Age Cohort ◽  
Before And After

One of the policy mechanisms aimed at improving population health through health care delivery is the Hospital Readmissions Reduction Program (HRRP) as outlined in the Affordable Care Act. Although numerous procedural and behavioral interventions have been implemented, the empirical evidence of the efficacy of these interventions is mixed and specific to certain patient segments. This review aimed to systematically assess studies of hospital interventions to reduce 30-day readmissions for specific diseases and populations. Following the PRISMA review checklist, searches were conducted from January 2000 to August 2018 in the MEDLINE and EMBASE databases using terms such as “patient readmission”, “readmit” and “re-hospitalization” in conjunction with disease terms such as “asthma”, “chronic obstructive pulmonary disease (COPD)” and “pneumonia”. Of 3,806 articles identified, 45 were included after a 3-step inclusion process. The age group most frequently considered among the studies was the 65 age cohort. Multidisciplinary collaborative interventions were most frequently effective for the subset of elderly, female, Caucasian, and heart failure patients. Interventions involving patient or family education delivered before and after care were most effective for racial minority, elderly, COPD, and heart failure patients. Telephone follow-up, tele-homecare, and medication reconciliation were largely found to be successful in reducing readmissions. Major gaps exist in identifying successful interventions for reducing 30-day readmissions among patients who sought treatment for sepsis, stroke, and replacement of the hip or knee. Our findings indicate an opportunity for researchers to further study, and for healthcare organizations to implement, more well-informed interventional strategies to reduce readmissions.

Neonatal palliative care: a practical checklist approach

2018 ◽  
Vol 10 (2) ◽  
pp. 191-195
Author(s):  
Naomi Taylor ◽  
Yi Fan Liang ◽  
Robert Tinnion
Keyword(s):  
Palliative Care ◽  
Pain Relief ◽  
Care Delivery ◽  
Case Note ◽  
Comfort Care ◽  
Care Services ◽  
Paediatric Palliative Care ◽  
Before And After ◽  
Palliative Care Services

ObjectivesFollowing publication of detailed national neonatal palliative care guidance, practical regional guidance, in the form of multidisciplinary ‘checklists’, was implemented aiming to improve the quality of neonatal palliative care.MethodsCase note audit was used to examine the quality of locally delivered neonatal palliative care before and after regional guidance implementation.Results27 patients were allocated to the ‘before’ cohort and 10 to the ‘after’ cohort. Introduction of the checklists was apparently associated with improvements in domains of pain relief and comfort care, monitoring, fluids and nutrition, completion of diagnostics, treatment ceiling decisions, resuscitation status and discussion with parents. Other support for parents was poorly adhered to.ConclusionRegional guidance improved some aspects of palliative care delivery though other areas remained suboptimal. Other strategies, for example, consultation with paediatric palliative care services, need to be considered to further improve the quality of palliative care delivered to babies with life-limiting illnesses.

Abstract P475: Dementia and Heart Failure a Community Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Sheila M Manemann ◽  
David Knopman ◽  
Jennifer St. Sauver ◽  
Suzette J Bielinski ◽  
Alanna M Chamberlain ◽  
...  
Keyword(s):  
Heart Failure ◽  
Care Delivery ◽  
Care Utilization ◽  
Risk Of Death ◽  
Department Of Health ◽  
Increased Risk ◽  
Before And After ◽  
Diagnosis Of Dementia ◽  
Icd 10

Background: The effective self-management of heart failure (HF) is highly dependent on cognitive function. Dementia frequently coexists with HF, but its exact prevalence and impact on health care utilization and death is not well understood. Methods: Residents from 7 southeast Minnesota counties with a first-ever code for HF (ICD-9 428 and ICD-10 I50) between 1/1/2012 and 12/31/2017 were identified. Dementia before and after the HF diagnosis was ascertained with codes recommended by the US Department of Health and Human Services. Patients were followed through 12/31/2018 for death and hospitalizations. Cox and Andersen-Gill models were used to examine associations between dementia (prior and post HF) and death and hospitalizations, respectively. Dementia after HF was analyzed as a time-dependent variable. Results: Among 6,312 patients with HF (mean age 75 years, 49% female), 636 (10%) had a prior diagnosis of dementia. After a mean (SD) follow-up of 3.1 (1.8) years, 601 (9.5%) patients were diagnosed with dementia post HF. The median time from HF to dementia was 1.3 years, with 43% of dementia cases occurring within 1 year and 64% within 2 years post HF. During follow-up, 2,678 deaths and 15,095 hospitalizations occurred. After adjustment, patients with dementia before HF had nearly a 2-times increased risk of death and 10% increased risk of hospitalization compared to those that did not have dementia (Table). Dementia after HF was associated with a 78% increased risk of death and 63% increased risk of hospitalization compared to those that did not have dementia. Conclusions: Approximately 10% of patients had dementia prior to HF and 10% develop dementia shortly after HF diagnosis. Patients with HF and dementia have an increased risk of death and hospitalization compared to dementia-free counterparts. These data underscore the importance of recognizing the presence and impact of dementia on outcomes in HF to optimize care delivery.

scholarly journals COVID-19 Risk Perceptions, Concerns and Affecting Factors of College Students

2021 ◽  
Vol 2 (6) ◽  
pp. 30-35
Author(s):  
Hulya Caskurlu ◽  
Hatice Ikiisik
Keyword(s):  
Online Education ◽  
University Students ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Affecting Factors ◽  
Significant Difference ◽  
Scale Scores ◽  
Before And After ◽  
Post Test ◽  
Health Related

In this study, we aimed to increase the knowledge, awareness, and normalization adaptation of university students about the disease with the pieces of training given by academicians about COVID-19 and thus contribute to the control of the epidemic. We also aimed at writing education on disease risk perceptions and anxiety levels related to COVID-19 disease. In the study, two weeks of online education were planned for university students on COVID19 disease. A questionnaire was prepared to give knowledge about the anxiety and risk perceptions of the students about COVID-19 disease. Questionnaire training and finally administered. It was analyzed with the SPSS 22.0 program. Whereas the number of students who answered the pre-education questionnaire was 116, 56 students completed the questionnaire at the end of the training. There was no intelligent difference in the risk perceptions of the students about getting sick and losing their lives from illness before and after education. There is no significant difference in the results of the Wilcoxon signed sum of ranks test for the GAD7 scale scores that made the post-test (p = 0.905, z = -0.11). Except for 9 students who did both tests, 107 pre-tests and 47 post-tests did not differ significantly between the groups in terms of disease risk and GAB7 grading (p> 0.05). As a result, the motivation of university students to participate in the struggle against the pandemic is weak. Ensuring that health-related university students, as well as students from different faculties, participate in the fight against COVID-19 with educational studies will be important in controlling the epidemic.

scholarly journals Knowledge of Nurses About the End of Life Care Towards Terminal Illnesses: a Cross-sectional Design

2021 ◽  
Author(s):  
Maha Subih ◽  
Rasmieh AL-amer ◽  
Domam Alomari ◽  
Duncan C Randall ◽  
Rima Darwish ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Delivery ◽  
Life Care ◽  
Cross Sectional ◽  
Care Education ◽  
Palliative Care Education ◽  
Effective Care ◽  
Cross Sectional Design

Abstract The preparedness of nurses in relation to providing palliative care is not always adequate, indeed, it is sometimes unsatisfactory; this may be caused by lack of knowledge and limited experience in end-of-life care. The purposes of the study were to assess the levels of registered nurses' knowledge about end of life care (EOLC), examine the relationships between EOLC knowledge and demographic variables, and explore predictors of EOLC knowledge. A cross-sectional design survey was conducted on Jordanian registered nurses (N =220). Data analysis included descriptive statistics, correlation, and multiple regression.The results showed that End-of-Life Professional Caregiver Survey (EPCS) mean total score was moderate to high (72.1 (SD ±13.6), Range 0-112). For EPCS subscales: Patient and family-centered communication, cultural and ethical values were moderately high, while effective care delivery subscale was low. Predictors were attending training in palliative care (p = 0.02), and working in the intensive care unit (p = 0.04). Thus, nurses need palliative care education, more attention is required in palliative care education on clinical skills, as well as weakness of effective care delivery. Also build palliative education into the core nursing curriculum.

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