Literature Review

Muslim community-engaged research highlights Muslim Americans' end-of-life-healthcare gaps and needs WisconsinMuslimJournal.org; by Sandra Whitehead; 12/20/24 Few Muslim Americans use hospice care, despite its posited benefits. A multi-sectoral team of academicians and community leaders in southeastern Wisconsin decided to find out why. ... Muslims are one of the fastest-growing religious communities in the United States, numbering between 3 to 5 million, with projections it will double by 2050. “With an aging Muslim population, there is a growing need for specialized healthcare services like hospice and palliative care,” the team’s research explains. ... Through a qualitative descriptive study with a Muslim patient and 10 family caregivers, the research team identified their perceptions of hospice care, ethical concerns and experiences. Among their varied perceptions, many saw it as useful only in the last hours of life. Participants also had ethical concerns about the use of sedative medication and with cessation of feeding terminally ill patients. Some had concerns about how hospice care might lead to unnecessary interventions or even hasten death. ...  The team is developing an informational resource, Islamic Bioethical Considerations for the End of Life: A Guide for Muslim Americans, to help Muslims who struggle when thinking about death and dying. 

Palliative care, mental health services underutilized in pancreatic cancer Healio; by Jennifer Byrne; 12/19/24 Individuals with pancreatic cancer underutilized palliative care and mental health services, according to a retrospective analysis. ... Researchers from Saint Louis University used electronic health record data from Optum’s Integrated Claims-Clinical Data set to identify 4,029 patients with newly diagnosed pancreatic cancer. The investigators then used ICD-9/10 codes to identify subsequent diagnoses of anxiety and depression, as well as palliative care consultations. ... Results showed higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%) among patients who had palliative care consultations than those who did not have documented consultations. ... Healio: Did any of your findings surprise you? Divya S. Subramaniam, PhD, MPH: It was unexpected to see that palliative care consultations, despite identifying higher levels of anxiety and depression, did not increase treatment rates for these mental health conditions. This suggests mental health might not yet be a central focus in palliative consultations, which often concentrate on managing physical symptoms.

States ranked by nurse communication Becker's Hospital Review; by Mackenzie Bean; updated 12/13/24 Hospitals in Louisiana, Minnesota, North Dakota, Nebraska and South Dakota have the highest nurse communication scores, while hospitals in the District of Columbia have the lowest, CMS data shows. CMS collects and publicly reports data on nurse communication as part of its HCAHPS survey data. The nurse communication measure assesses the percentage of patients who reported that their nurses "always" communicated well. The data was collected in 2023 and published in CMS' Provider Data Catalog Oct. 30. Nationwide, 80% of patients reported nurses always communicated well, up one percentage point from the year prior, according to CMS data. [Click on the title's link for this ranked list.]

Palliative medicine for the community paramedic Journal of Emergency Medical Services (JEMS) - The Conscience of EMS; by Maurice Paquette; 12/17/24 The role of the paramedic is evolving. ... EMS has become a catch-all, a gateway into a somewhat—if not totally—fractured healthcare system. ... The landscape of healthcare is shifting as well. The pandemic, coupled with the realization of self-care, well-being, and mental health struggles has caused drastic reduction in the number of healthcare workers, and the amount of experience in skills that those healthcare workers carried with them. ... Over the past many years, we’ve seen a push for the idea of the community paramedic, as well as mobile healthcare. The establishment of a community paramedic program, especially in rural areas of the United States, would provide non-emergent care, under expanded scope and under the direction of a physician in the patient’s home.  According to a literature review in the International Journal of Paramedicine, the most common community paramedic program goals are to “aid patients in chronic disease management, reduce emergency department visits, reduce hospital admissions/readmissions, and reduce Healthcare costs.” Editor's note: Pair this with the article we posted yesterday, Characteristics of patients enrolled in hospice presenting to the emergency department.

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

University of Michigan Health-Sparrow nurses authorize strike as contract negotiations continue CBS News, Detroit, MI; by Elle Meyers; 12/12/24 Union officials representing the University of Michigan Health-Sparrow nursing staff have been working for months for an improved contract, but leaders say they're not close to a deal. "The hospital so far is not making offers that are going to keep up competitive. It's not going to allow us to make sure we maintain our level of care or quality of care," said Jeff Breslin, a registered nurse and the president of the Professional Employees Council of Sparrow Hospital. The University of Michigan bought Sparrow last April. Bresil says he was hopeful for positive change. "They had promised to come in and build new facilities, improve other facilities that we have, which is great, but you've got to take care of the people as well, and frankly, I'm disappointed that this is the direction things are taking," he said. Breslin said contract negotiations between the nurse's union and the hospital began last August. Their contract expired in October, and they still haven't reached a deal. He says nurses want to see more competitive pay, better staffing levels and an improved health plan. 

Northern Colorado cancer palliative care nurse leans on patients as she battles her own diagnosis ABC KJCT News 8, Fort Collins, CO; by Dillon Thomas; 12/11/24 A Northern Colorado woman who has spent years of her career helping patients navigate their cancer diagnosis says she leaned on her own patients for encouragement as she battled cancer herself. Riley Mulligan, a palliative care nurse navigator for UCHealth in Fort Collins, said she was able to battle her diagnosis of breast cancer by leaning into the courage of her patients while also taking lessons from herself. Mulligan’s journey battling cancer started nearly a decade ago, but the cancer she was helping battle wasn’t her own at the time. As a palliative care nurse, her job was to help some of the most ill patients that UCHealth treats. ... “I’m trying to take my own advice, I am trying to remember how to live. On the days I felt the worst, the most nauseous and tired, I still tried to get out and do things because I knew it would help me feel better,” Mulligan said.

Early successes, untapped potential, lingering questions: AI Adoption in Healthcare Report 2024 Medscape; by Jon McKenna; 12/6/24 ... For this report, Medscape partnered with Healthcare Information and Management Systems Society (HIMSS), a global professional society that includes an interest group focused on AI-related issues. ... Data came from a jointly managed survey to practicing physicians and other clinicians, practicing nurses, IT professionals, clinical leadership, and executive leadership at medical organizations. All respondents were in the U.S. 

HSPN Staffing Summit: Leveraging technology for person-centered care Hospice News; by Sophie Knoelke; 12/9/24 This article is sponsored by CareXM. This article is based on a virtual discussion with Kathleen Benton, President and CEO of Hospice Savannah. ... Dr. Benton has a master’s degree in medical ethics and a doctorate in public health. She has offered and reviewed many publications relevant to the topics of palliative care, ethics, hospice, and communication. [Dr. Benton:] I was schooled in clinical ethics and really mediating ethical dilemmas in health care. Looking at, is this in the best interest of the patient? Are we truly following the patient’s wishes? Many of the dilemmas, I would say a good 90%, occur at the end of life. ... [At] the root of [really trending] cases was one missing element. That element was the lacking area of communication. What do I mean by that? I believe that health care does the worst job of probably all other areas of communicating with folks. We have really taken what it is to be human out of what it is to treat a patient and a person. [Click on the title's link to continue reading this insightful discussion.]

Dr. James O’Connell on caring for the homeless in Boston Simmons University, Boston, MA; by Simmons University; 12/6/24 “A mile from here, people are experiencing the same health disparities as they have in Third World countries,” said Dr. James O’Connell, founder and president of Boston Health Care for the Homeless Program (BHCHP) and Assistant Professor of Medicine at Harvard Medical School. ... In 1985, O’Connell was the founding physician of a program to support the people experiencing homelessness in Boston. The program received funding through a four-year grant from the Robert Wood Johnson Foundation and the Pew Charitable Trust. ... [Story about getting a homeless man into hospice care at a nursing home.] When [O'Connell] questioned him about hospice, Santo shared his perspective. “He told me, ‘I appreciate all you’ve done, but I didn’t know anyone there. I don’t want to die there. I want to die with my friends.’” After that, they arranged end of life care for Santo at the shelter. “I had never thought to ask him what he wanted,” said O’Connell. “I have since learned that I have to listen to what people want.” 

Caring for patients at the end of life: CEJA reports AMA - American Medical Association; by Council on Ethical and Judicial Affairs (CEJA); 12/2/24 Reports by the Council on Ethical and Judicial Affairs (CEJA) interpret the AMA Principles of Medical Ethics to provide practical ethics guidance on timely topics. When the AMA House of Delegates adopts the recommendations of a CEJA report they become Opinions in the Code of Medical Ethics. The body of the report, which sets out CEJA’s ethics analysis, is archived and remains available as a resource to help users apply guidance. CEJA reports may not be reproduced without express written permission. [Click here to access these CEJA reports.]

Nurse burnout and patient safety, satisfaction, and quality of care-A systematic review and meta-analysisJAMA Network Open; Lambert Zixin Li, MPhil; Peilin Yang, BS; Sara J. Singer, PhD, MBA; Jeffrey Pfeffer, PhD; Maya B. Mathur, PhD; Tait Shanafelt, MD; 11/24Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. In this systematic review and meta-analysis of 85 studies including 288,581 nurses, nurse burnout was associated with a lower patient safety climate and patient safety grade; more nosocomial infections, patient falls, medication errors, and adverse events; lower patient satisfaction ratings; and lower nurse-assessed quality of care. The associations were consistent across nurse age, sex, work experience, and geography. These findings suggest that systems-level interventions for nurse burnout may improve patient outcomes.

Pet Peace of Mind program alleviates stress for hospice patients Poteau Daily News; by Ashley Torres; 11/26/24 Heart of Hospice in Poteau has announced a new program that will be helping with pet care while patients are on hospice care. The Pet Peace of Mind program, which began at Heart of Hospice Poteau on Nov. 15, aims to support the bond between pets and hospice patients during their final days. According to Heart of Hospice, the Pet Peace of Mind program “recognizes and actively supports the unique bond between hospice patients and their pet,” and “aligns with the Heart of Hospice mission to provide exceptional care and unparalleled service to the patients and families who have placed their trust in us.” The program is funded through donations, and the work is done by volunteers.  ... The Pet Peace of Mind program is aptly named, because it is all truly done to alleviate the anxiety and stress that hospice patients often feel while worrying about what will happen to their beloved pets when they are gone. Knowing that their pet’s needs are being met while they are on hospice care, and knowing that their pet will be taken care of even afterwards, allows the patient to focus on their own comfort during their last days.