The American journal of hospice care最新文献

{"title":"Hospice accreditation: a useful tool for quality assurance.","authors":"N S Murray","doi":"10.1177/104990918900600411","DOIUrl":"https://doi.org/10.1177/104990918900600411","url":null,"abstract":"Another survey! I can’t take anymore! That was my responsewhenI beganto considervoluntary accreditation by the Joint Commissionon Accreditationof HealthcareOrganizations(JCAHO) a coupleof yearsago. I thenattendeda JCAHO seminar whichhelpedmecalmdown.Thefocus was on quality careandthepresenters werebrightandreceptive. In manyways the philosophyand goalsof hospicealign with this objective. Yearsago,it becamecleartomany astheyevaluatedotherhealthcaresystems,thattheneedsoftheterminallyill werenotbeingmet.Sincetheirinception, hospice programs have demonstratedastrongcommitmento quality care.AccordingtoJCAHO,one of themajorobjectivesof accreditation is the advancementof this country’svoluntary effortsto evaluate and improve the quality of care providedby healthcareorganizations.”It is importantto keepin mind thatthe primary objectivesof JCAHO and hospiceprogramsareinagreement. Oncewedecidedto havethesurvey done,thenextstepwaspreparationand implementation. It ishelpful to setup a targetdatefor the survey.This motivates personnelto set up a planto accomplishthe tasksand implementthe changesmostlikely toberequiredonce anevaluationis completed.In ourparticular situation, the targetdatechangedtwice dueto changesin personnel and areorganizationwithin agencyin which the hospiceis based.Once the preparationis substantiallycomplete, the applicationshouldbefiled. The key to a successfulaccreditation surveyis theinclusionof thestaff andboardmembersin the process.At first, we gatheredtogetherinformally anddid afreeflowing overviewof the program.All disciplinesidentified the strengthsand weaknessesof the hospice.Wethenbrainstormedsomesolutions to the problem areasidentified. Our strengthswere emphasizedwith thegoalthattheybe maintainedor enhancedby any changeswe decidedto implement.This meetinghelped all personnelrealize their role and responsibility to makethe hospicethe bestit couldbe.It alsocreatedanatmospherethatmotivatedthe staff toward the accomplishment of ourgoals. A sub-committeewith representationfrom the staff and board workedtoward formalizingtheobjectives,goals,andtasksto improvethe program and satisfy accreditation standards. It is significantthatsatisfyingstandards wasnottheprimaryfocus of the initial meeting.Themainobjective wasto enrichthe programandthe qualityofcareprovided.ThesubCommittee then reviewedthe JCAHO Hospice StandardsManual and HospiceSelf-Assessment and Survey Guide; while evaluatingthe program and determiningwhattasksneededto be accomplished.The committee developedan outline of goalsandobjectives using the standardJCAHO framework,the informationfrom the informal staffmeetingandthe policy andproceduremanuals.Whenreviewing the policies andproceduresof the program,the committeealwaysasked thequestions:","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"44-6"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospice and hope: can a patient have both?","authors":"S C Jones","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"8-9"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The study of grief: an in-depth look at a response to loss.","authors":"T L Martin","doi":"10.1177/104990918900600410","DOIUrl":"https://doi.org/10.1177/104990918900600410","url":null,"abstract":"The struggleto accommodateloss, as a fact of life, permeateseachstage of humandevelopmentand typifies much of the individual’s efforts to cometo termswith the issueof mortality. As Kalishobserved:“Anything you haveyou can lose; anything you are attachedto, you can be separated from; anything you love canbe taken from you. Yet, if you really havenothing to lose, you havenothing.”14The earliest theoretical formulation explaining loss is generallycreditedto Freudwhobelievedgriefwasaprocess by whichtheindividualprogressively withdrewtheenergythattieshimorher to the objectof his or her love. This energywasconceivedby Freudasbeing boundto the memoriesandideas that arosefrom interactionswith the deadperson. This processof energy withdrawalwas achievedby aprocess that Freudtermed“hypercathexis,”a processthat requiredthe mournerto turnhis backon the real world andto invest free energy in the struggle to decathect thelovedobject.’°","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rectal administration of MS Contin: clinical implications of use in end stage cancer.","authors":"C M Maloney,&nbsp;R K Kesner,&nbsp;G Klein,&nbsp;J Bockenstette","doi":"10.1177/104990918900600409","DOIUrl":"https://doi.org/10.1177/104990918900600409","url":null,"abstract":"<p><p>Mercy Hospice in Nampa, Idaho administered unmodified MS Contin 30 mg tablets rectally to 39 terminally ill patients. All patients had pain controlled on oral MS Contin but were switched to the rectal route of administration because of intractable nausea, inability to swallow or both. Pain control was maintained on all patients receiving rectal MS Contin. In 11 patients, the dosage of MS Contin was decreased. No local or systemic adverse reactions developed. The rectal administration is a safe, effective and simple means of maintaining pain control in terminally ill patients.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"34-5"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echoes of silence: death and denial.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"5, 46"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A report whose time has come.","authors":"J A Wallace","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13627824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraventricular morphine administered by hospice nurses to a patient with intractable pain.","authors":"D W Carlisle,&nbsp;K A Smith,&nbsp;E Frank,&nbsp;F J Meyers","doi":"10.1177/104990918900600402","DOIUrl":"https://doi.org/10.1177/104990918900600402","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 4","pages":"36-9"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on echoes of silence: death and denial.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 3","pages":"5-7"},"PeriodicalIF":0.0,"publicationDate":"1989-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A specialized hospice for dementia patients and their families.","authors":"B G Brechling,&nbsp;D Kuhn","doi":"10.1177/104990918900600303","DOIUrl":"https://doi.org/10.1177/104990918900600303","url":null,"abstract":"<p><p>This article reports the development of a small pilot program and briefly describes its activities. The growing number of dementia patients in American communities indicates a need to extend hospice services to these patients and their families. It is difficult to determine at present whether this need could be met more effectively by encouraging existing hospices to accept these patients or by establishing specialized programs such as this one. Research in this area is indicated, as well as the sharing of information among hospices providing care to other specialized groups--people with AIDS or terminally ill children for example. The Alzheimer's Family Care Hospice has provided services to eight terminally ill dementia patients and their families in a pilot project sponsored jointly by the Rush Alzheimer's Disease Center and the Chicago Area Chapter of the Alzheimer's Association. Another six patients did not meet admission criteria.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 3","pages":"27-30"},"PeriodicalIF":0.0,"publicationDate":"1989-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State associations' role in promoting the hospice concept.","authors":"P L Morgan","doi":"10.1177/104990918900600311","DOIUrl":"https://doi.org/10.1177/104990918900600311","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 3","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"1989-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13748011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}