Literature Review

Saturday newsletters focus on headlines and research - enjoy!

Addressing challenges with sedation in end-of-life careJournal of Pain and Symptom Management, by Columba Thomas, MD; Yesne Alici, MD; William Breitbart, MD; Eduardo Bruera, MD; Liz Blackler, MBE, LCSW-R; Daniel P. Sulmasy, MD, PhD; 4/24Unfortunately, little is known about actual sedation practices at the end of life in the United States. This may be due in part to a lack of conceptual clarity about sedation in end-of-life care. We argue that, until more is known about what sedation practices occur at the end of life, and how practices can be improved by research and more specific guidelines, “palliative sedation” will remain more misunderstood and controversial than it might otherwise be. 

Changing the landscape of the neighborhood : The expanding role of the Pediatric Palliative Advanced Practice Registered NurseJournal of Hospice & Palliative Nursing, by Nicole Sartor, Alice K Bass, Kayla Overstreet; 4/24There is a dearth of information on the role of the pediatric palliative advanced practice registered nurse (APRN) reported in the literature, and yet, the role is expanding. Advances in technology and health care are helping children with medical complexity live longer, and the demand for pediatric palliative care is growing. ... The aim of this article was to describe the expanding role of the pediatric palliative APRN...

Exploring parent experiences with early palliative care practices in the NICUAdvances in Neonatal Care, by Megan Quinn, Sheila Gephart, Janice Crist; 4/24Parents' descriptions of decision-making were contextualized in gathering information to make a decision, the emotional impact of the decision, and influences on their decision-making. In experiences with care planning, parents described learning to advocate, having a spectator versus participant role, and experiencing care planning as communication. Key themes expressed regarding parental coping were exposure to trauma, survival mode, and a changing support network.

We are not okay: Moral injury and a world on fireAmerican Journal of Bioethics, by Keisha S. Ray; 4/24Moral injury gives name to a feeling that I have been having lately as I’m asked to show up to work and my life as if there aren’t people who didn’t wake up today because of violence, disease, and greed. I’ve celebrated holidays and my own professional accomplishments, but I can’t escape that lump in my throat, that nagging feeling that this is all meaningless given the state of the world. After all, my principles won’t feed the starving, shelter the bombed, free the captive, or care for the sick. I don’t have the answer. I do not know what we are supposed to do about our perpetual moral injury. I do find some comfort in the origins of moral injury—calling out a broken system rather than broken individuals (Talbot and Dean Citation 2018). I am not broken; I am just a bioethicist and a human forced to work and live within a broken world.

New York’s home health, personal care workforce achieves fastest growth in nation: BLS McKnights Home Care, by Adam Healy; 4/10/24 New York is adding home health and personal care jobs faster than any other state, growing its supply of such workers by 12% between May 2022 and May 2023, according to new data from the Bureau of Labor Statistics. The state added roughly 62,000 home health and personal care aides during that time period, which was more than double that of any other state and accounted for over one third of nationwide home care aide employment growth, according to an analysis by the Empire Center, an independent, nonpartisan, nonprofit think tank based in New York. 

Overcoming key diversity gaps within the healthcare continuum MedCity News, by Alexandra Moens; 4/9/24Leaders need a framework to identify, understand, effectively address diversity gaps, and measure improvement across the continuum of care. A data-driven approach can provide valuable insights into demographic trends, disparities in healthcare access and outcomes, and the underlying factors contributing to these discrepancies. Disparities in diversity and inclusion continue to permeate every aspect of healthcare. ... In the U.S., stark statistics reveal the extent of these imbalances. Only about 36% of active physicians are female, with even fewer identifying as non-White. While Black and Hispanic Americans comprise a considerable portion of the population, their representation among healthcare practitioners is disproportionately low. 

New patient safety measures imminent as risk of harm evolves: CMS McKnights Long-Term Care News, by Kimberly Marselas; 4/10/24 The Centers for Medicare & Medicaid Services remains acutely focused on patient harm and will introduce new measures addressing patient safety later this year, agency leaders said at an event in Baltimore Tuesday. ... Agency officials are working with other Health and Human Services branches and meeting internally to develop a 10-point patient safety strategy to be unveiled later this year. 

PeaceHealth nurses announce plan to picket outside hospital April 18 The Columbian, by Chrissy Booker; 4/10/24 Nurses at PeaceHealth Southwest Medical Center in Vancouver will picket outside the hospital April 18. ... The bargaining unit, which includes 1,465 nurses, is negotiating with the hospital for a new three-year contract. According to a news release from the union, “management has not agreed to the association’s proposed workplace protections, staffing commitments or market-rate wages.” PeaceHealth countered that its proposals have been “highly competitive.”

Why so many nurses are fleeing healthcare — and how hospitals can address the problem MedCity News, by Katie Adams; 4/10/24Nearly one-fifth of nurses are projected to leave the healthcare workforce by 2027. The American Organization for Nursing Leadership published a report revealing one of the biggest reasons nurses are exiting the industry: their managers are too busy to train and support them.

Friday. The golden child of the weekdays. The superhero of the workweek. The welcome wagon to the weekend. — Anonymous

Providers still navigating Change outage as systems are restored Modern Healthcare, by Lauren Berryman; 4/10/24 Providers are seeing some improvements following the Change Healthcare cyberattack nearly two months ago, but not necessarily because they are reconnecting to restored systems. Hospitals and medical groups are submitting claims to payers through alternate vendors, allowing them to generate cash. But the level of claims and payments moving among healthcare organizations that had heavily relied on Change Healthcare is still far from normal.

Valley Health and Blue Ridge Hospice expand partnership to offer hospice care at Shenandoah Memorial HospitalABC WHSV Fox TV 3, by Colby Johnson; 4/10/24 Valley Health and Blue Ridge Hospice are expanding their partnership to be able to offer their collaborative ‘Hospice in the Hospital’ program at Shenandoah Memorial Hospital in Woodstock. The program will allow patients at Shenandoah Memorial to receive end-of-life hospice care.