Journal of Hospice & Palliative Nursing最新文献_第2页

Increasing Goals of Care Review and Fiscal Implications With an Embedded Palliative Care Specialist in the Emergency Department: A Quality Improvement Project at a Community-Based Hospital. 急诊科内嵌姑息治疗专家增加护理审查目标和财政影响：社区医院的质量改进项目。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-10-01 Epub Date: 2025-08-28 DOI: 10.1097/NJH.0000000000001135

Rachel A Butler, Joy Elwell, Emilee Binette, Mary Jane Bowles

{"title":"Increasing Goals of Care Review and Fiscal Implications With an Embedded Palliative Care Specialist in the Emergency Department: A Quality Improvement Project at a Community-Based Hospital.","authors":"Rachel A Butler, Joy Elwell, Emilee Binette, Mary Jane Bowles","doi":"10.1097/NJH.0000000000001135","DOIUrl":"10.1097/NJH.0000000000001135","url":null,"abstract":"Patients with terminal illnesses presenting to the emergency department (ED) may be admitted to the hospital receiving aggressive treatment that will not reverse the dying process and is not aligned with their wishes. Misdirected, incongruous care negatively impacts the comfort of the patient and increases health care costs. This project aimed to determine if embedding a palliative care nurse practitioner in the ED at a community-based hospital is a meaningful method for addressing goals of care early in the preadmission period, with the potential secondary benefit of improved fiscal health of the system. A preintervention and postintervention EPIC (electronic medical record) review was done to evaluate change in readmission rates, hospice and palliative care referrals, and advance care planning sessions. The target population was adults presenting to the ED with an expected mortality within 6 months. An EPIC-generated report compared how many similar patients, during the same month, 1 year prior (November 2022), explored goals of care in the ED (as evidenced by above measures). Exploring goals of care in the ED for patients with terminal illnesses may lead to a more comfortable death and result in better utilization of resources, reduced unnecessary admissions, and cost savings to the hospital system.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"262-268"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-10-01 Epub Date: 2025-08-21 DOI: 10.1097/NJH.0000000000001171

引用次数: 0

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-10-01 Epub Date: 2025-08-21 DOI: 10.1097/NJH.0000000000001148

Abigail G Cohen, Dana Kramer, Kathryn Mazzarella, Megan H Scott, Mia Szkolnicki, Alli Tucker, Kelley Qualters, Miguel-Angel Perales, Chelsea Brooklyn, Andrew S Epstein, Judith E Nelson, Nicole Lestrange

{"title":"Health-Related Values Discussions With Patients Receiving Allogeneic and Autologous Stem Cell Transplant and Chimeric Antigen Receptor Therapy (CAR-T): Implementation of an Early Nurse Practitioner-Led Primary Palliative Care Intervention.","authors":"Abigail G Cohen, Dana Kramer, Kathryn Mazzarella, Megan H Scott, Mia Szkolnicki, Alli Tucker, Kelley Qualters, Miguel-Angel Perales, Chelsea Brooklyn, Andrew S Epstein, Judith E Nelson, Nicole Lestrange","doi":"10.1097/NJH.0000000000001148","DOIUrl":"10.1097/NJH.0000000000001148","url":null,"abstract":"Patients undergoing hematopoietic stem cell transplant and chimeric antigen receptor-T cell therapy face significant uncertainty, distress, risk of serious treatment-related complications, and disease relapse. Although palliative care and advance care planning offer clear benefits, both remain underutilized or delayed in this patient population. To address this gap, a nurse practitioner (NP)-led primary palliative care intervention was implemented in the outpatient Bone Marrow Transplant and Cellular Therapy Services at a comprehensive cancer center. This paper provides an overview of the program model, involving NP-led health-related values and care preferences discussions with patients and their families. This highlights the pivotal role of NPs in delivering primary palliative care by integrating values-based discussions into routine oncology practice. Future goals include evaluating the intervention's impact on patient and caregiver outcomes, clinician understanding, care alignment with patient's goals, advance directive completion, and high-intensity care at the end of life.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"223-229"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early Integration of Palliative Care Services in Pediatric Stem Cell Transplant Patients. 儿童干细胞移植患者姑息治疗服务的早期整合。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-09-09 DOI: 10.1097/NJH.0000000000001167

Laurel Kent, Molly Williams, Lisa Pinner, Elizabeth Callard, Joan Fisher, Kimberly A Pyke-Grimm

{"title":"Early Integration of Palliative Care Services in Pediatric Stem Cell Transplant Patients.","authors":"Laurel Kent, Molly Williams, Lisa Pinner, Elizabeth Callard, Joan Fisher, Kimberly A Pyke-Grimm","doi":"10.1097/NJH.0000000000001167","DOIUrl":"10.1097/NJH.0000000000001167","url":null,"abstract":"Patients undergoing hematopoietic stem cell transplant are at risk for significant morbidity and mortality throughout their treatment course. The aim of this evidence-based practice project was to determine if the use of a palliative care trigger tool impacted the number of palliative care consults and/or the early integration of palliative care services within the pediatric hematopoietic stem cell transplant patient population. A trigger tool was developed to identify patients at highest risk for stem cell transplant-associated morbidity and mortality. It was implemented on a 24-bed pediatric stem cell transplant unit over a 6-month period. Based on a retrospective chart review, 35% of patients met criteria for early integration of palliative care services, while 29% of those who qualified received services. After the implementation of the trigger tool, 27 patients underwent stem cell transplant, and 52% qualified for palliative care integration while it was received by 80%. The tool was determined to be effective in identifying patients for early integration of palliative care services and providing these services to identified patients. Providing early palliative care during stem cell transplant with a focus on symptom management, quality of life, and decision-making is a priority of care for patients undergoing stem cell transplant.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementing Education for Community Adult Hospice Nurses to Expand Pediatric Hospice and Palliative Care. 实施社区成人安宁疗护护士教育，拓展小儿安宁疗护与缓和疗护。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-08-22 DOI: 10.1097/NJH.0000000000001151

Shelly C Wenzel

{"title":"Implementing Education for Community Adult Hospice Nurses to Expand Pediatric Hospice and Palliative Care.","authors":"Shelly C Wenzel","doi":"10.1097/NJH.0000000000001151","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001151","url":null,"abstract":"Children with life-limiting illnesses living in nonurban areas have minimal access to community-based pediatric hospice and palliative care. Barriers such as geography, limited continuing education opportunities, and clinician discomfort compound this issue. Pediatric hospice and palliative patients require specially-trained clinicians to provide holistic support in areas such as disease progression, illness trajectory, and goals of care. An asynchronous online educational module, including a pre- and postmodule survey, was developed to provide education on timely pediatric quality-of-life conversations and skills for nurses who work with the adult population. This evidence-based project compared findings on knowledge, comfort, confidence, and willingness for adult hospice and palliative nurses in caring for pediatric patients. Registered nurses from 3 community hospice and palliative agencies were invited to participate. Following the education module, participants reported an increase in comfort from 25% to 93.3% and willingness from 59% to 93.3%. Additionally, postmodule confidence level increased to 94%. These findings suggest an asynchronous educational module approach benefits the needs of community-based adult hospice and palliative nurses and gains learned from this module may enhance nurse skill and improve access to care.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fostering Compassionate Spirituality: The Participatory Model for Palliative Care Education. 培养富有同情心的灵性：姑息治疗教育的参与式模式。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-08-22 DOI: 10.1097/NJH.0000000000001157

Pilaiporn Sukcharoen, Nanchatsan Sakunpong, Jidapa Polruk, Praditporn Pongtriang, Aranya Rakhab

{"title":"Fostering Compassionate Spirituality: The Participatory Model for Palliative Care Education.","authors":"Pilaiporn Sukcharoen, Nanchatsan Sakunpong, Jidapa Polruk, Praditporn Pongtriang, Aranya Rakhab","doi":"10.1097/NJH.0000000000001157","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001157","url":null,"abstract":"Patients with terminal illnesses often endure profound physical, emotional, and spiritual distress. Nursing students play a vital role in alleviating this suffering through compassionate and holistic care. This study developed and evaluated a participatory model of palliative care education designed to enhance nursing students' spirituality in clinical practice. A mixed-method design was employed. Ten fourth-year nursing students engaged in focus group discussions to co-develop the model, which was subsequently implemented with third-year nursing students. Quantitative data were analyzed using means and standard deviations. The model comprises 4 sequential components: (1) simulated scenarios and case studies; (2) reflective conversations to explore patients' end-of-life needs; (3) relationship building with patients and their families; and (4) planning care transitions to home and community settings. The findings indicated a statistically significant improvement in nursing students' spirituality scores, increasing from a pre-intervention mean of 53.56 (SD = 3.87) to 56.87 (SD = 2.81) immediately after the intervention. This participatory model provides a structured and evidence-informed framework for nurse educators to cultivate spiritual awareness and compassionate care competencies among future palliative care nurses.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integrating the Clinical Nurse Specialist Into a Multi-State Hospice in a Large Healthcare System. 将临床专科护士纳入大型医疗保健系统中的多州临终关怀。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-08-22 DOI: 10.1097/NJH.0000000000001155

Jennifer Jarrett Lee, Melissa Robinson

引用次数: 0

Serious Illness Communication in Homecare Nursing: A Concept Analysis. 家庭护理中的大病沟通：概念分析。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-08-22 DOI: 10.1097/NJH.0000000000001153

Christine S Davidson, Olga Ehrlich, Toni L Glover

{"title":"Serious Illness Communication in Homecare Nursing: A Concept Analysis.","authors":"Christine S Davidson, Olga Ehrlich, Toni L Glover","doi":"10.1097/NJH.0000000000001153","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001153","url":null,"abstract":"Many seriously ill patients receive nursing care at home to manage their illness. There is a growing overlap between homecare and palliative or hospice care. In the homecare setting, nurses may be uncertain about their role and responsibility for engaging in \"serious illness communication.\" The term \"serious illness communication\" is sometimes used ambiguously, overlapping with other terms such as goals of care discussions or end-of-life conversations. Proponents of serious illness communication emphasize the need for a shift from traditional advance care planning toward a real-time, patient-centered dialogue adaptive to the evolving nature of serious illness. These combined factors highlight the need for further clarification and standardization of the concept, particularly for homecare nurses. The purpose of this project was to analyze the concept of serious illness communication within the context of homecare nursing. A literature review and concept analysis using the method defined by Walker and Avant were performed. A review of the literature highlighted key attributes, including the importance of a relationship focus that is driven by patient values and understanding, is appropriately timed, and incorporates a multidisciplinary team process. This concept analysis discusses the concept and use of serious illness communication as a responsive strategy for meeting a patient's evolving goals and preferences.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of PMHNPs in Palliative Psychiatry: An Ethical Framework for Care When Remission Is Unattainable. PMHNPs在姑息精神病学中的作用：当无法达到缓解时护理的伦理框架。

IF 1.3 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-08-22 DOI: 10.1097/NJH.0000000000001158

Trae Stewart

{"title":"The Role of PMHNPs in Palliative Psychiatry: An Ethical Framework for Care When Remission Is Unattainable.","authors":"Trae Stewart","doi":"10.1097/NJH.0000000000001158","DOIUrl":"https://doi.org/10.1097/NJH.0000000000001158","url":null,"abstract":"Patients with serious and persistent mental illness may experience intractable suffering despite exhaustive treatment, challenging the dominant curative paradigm in psychiatry. Palliative psychiatry offers an emerging alternative-prioritizing comfort, dignity, and quality of life when remission is no longer attainable. This article presents a comprehensive ethical and clinical framework for integrating palliative psychiatry into psychiatric-mental health nurse practitioner (PMHNP) practice. Drawing parallels with somatic palliative care, the author explores the theoretical foundations, diagnostic complexities, and ethical imperatives guiding palliative psychiatry. The article delineates PMHNP competencies in prognostic assessment, symptom management, advance-care planning, and interprofessional collaboration. Legal challenges, such as hospice eligibility criteria and involuntary treatment statutes, are also examined, with recommendations for practice and policy reform. Through this synthesis, the author argues that PMHNPs are ideally positioned to lead a paradigm shift that upholds the humanity of patients at the limits of recovery.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Associated With the Management of Pressure Injuries at the End of Life: A Scoping Review. 与临终压力损伤管理相关的因素：范围综述。

IF 1.2 4区医学

Journal of Hospice & Palliative Nursing Pub Date : 2025-08-01 Epub Date: 2025-03-21 DOI: 10.1097/NJH.0000000000001119

Pauline Catherine Gillan, Christina Parker

{"title":"Factors Associated With the Management of Pressure Injuries at the End of Life: A Scoping Review.","authors":"Pauline Catherine Gillan, Christina Parker","doi":"10.1097/NJH.0000000000001119","DOIUrl":"10.1097/NJH.0000000000001119","url":null,"abstract":"Pressure injuries are a major problem in all health care settings. The incidence of pressure injuries at the end of life is as high as 58% in some facilities, and there is little consensus on how pressure injuries are managed at the end of life. A scoping review was conducted, to investigate what is known of the factors associated with the management of pressure injuries at the end of life. Literature was sourced from several databases. A total of 1760 potential sources were identified; after applying the Population Concept Context inclusion and exclusion criteria, 16 empirical research articles were sourced: 10 were quantitative, 5 were qualitative, and 1 was mixed methods. Studies were published between 2003 and 2021 and originated from Italy, the United States, Australia, Sweden, Brazil, Taiwan, Turkey, and Canada. Key interventions included regular second hourly turning, wound debridement, wound assessment, and application of various wound coverings. The most widely discussed management strategy, regular second hourly turning, proved controversial and inconsistent in practice. There were also inconsistencies with wound assessment, with practice not always following best evidence-based assessment guidelines. Research findings also highlighted issues with prognostication and identification of the end-of-life phase with no consistent tool applied to assist end-of-life pressure injury management decision-making.","PeriodicalId":54807,"journal":{"name":"Journal of Hospice & Palliative Nursing","volume":" ","pages":"E144-E151"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0