Literature Review

Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia JAMA Health Forum - JAMA Network; by Cyrus M. Kosar, PhD; Bishnu B. Thapa, MPA, PhD; Ulrike Muench, RN, PhD; Christopher Santostefano, RN, MPH; Emily A. Gadbois, PhD; Hyesung Oh, MA, MBA; Pedro L. Gozalo, PhD; Momotazur Rahman, PhD; Elizabeth M. White, APRN, PhD; 5/10/24 Question: Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full vs restrictive NP scope of practice regulations? Findings: The results of this cohort study including 334 618 US nursing home residents with ADRD indicated that decedents with greater NP involvement at end of life had fewer hospitalizations and higher hospice use. The adjusted differences in outcomes between decedents with extensive vs minimal NP care were larger in states with full scope of practice regulations than in states with restrictive regulations.

WSNA files unfair labor practice charge against PeaceHealth Southwest after 14 bargaining sessions WSNA - Washington State Nurses Association; 5/9/24 After 14 negotiation sessions for a new contract, WSNA filed unfair labor practice charges against PeaceHealth Southwest Medical Center on behalf of the 1,465 nurses the association represents at the facility. Nearly four months after bargaining began, the parties remain far apart on core contract issues like wages, sick leave benefits, and workplace violence prevention. Their previous contract expired on Feb. 28, 2024. ... One of the key issues over which PeaceHealth Southwest has refused to compromise is pay equity for home health and hospice nurses in the bargaining unit. ... PeaceHealth’s proposal would put home health and hospice nurses up to 5% behind their coworkers working at the hospital.

What nurses really need is better staffing: The common strategies to raise nurse morale need an updatePenn LDI - Leonard Davis Institute of Health Economics; by Karen Lasater, PhD, RN, and Jane Muir, PhD, APRN; 5/10/24Pizza. Coloring books. Goody bags. They could be activities at a 5-year-old’s birthday party. But they’re not: These are many employers’ attempts to lift the morale of nurses on the frontlines of chronically understaffed organizations. What nurses really want are better working conditions so they can deliver the best care possible to their patients. As researchers at the University of Pennsylvania School of Nursing, we asked thousands of nurses why they are leaving their profession. Their answers are straightforward — short staffing is so rampant that the public’s health care is at risk. The playbook of corporate health care asks nurses to do much with little, but nurses aren’t willing to skimp on quality and safety. There isn’t a nursing shortage — it’s nurses’ refusal to be part of a system that puts profits before safety.

Honoring National Nurses Week: 11 hospital executives' thank-you notes to nurses Becker's Clinical Leadership; by Mariah Taylor and Kelly Gooch; 5/6/24 The American Nurses Association's theme of National Nurses Week, "Nurses Make the Difference," highlights nursing excellence and how nurses embody the spirit of compassion and care in every healthcare setting. ... [Click on the title's link for] Becker's collected messages of appreciation from hospital and health system leaders across the U.S. ...

What every family should know about navigating hospice care: The keys to experiencing a peaceful, gentle, and dignified death Psychology Today; by Bob Uslander, MD; 5/7/24... As a physician with 35 years of experience, including 25 years as an emergency physician and 10 years as a palliative and end-of-life care specialist, I've witnessed firsthand the stark realities of palliative and hospice care.  ... Let me be clear: Hospice care is an enormous benefit to many people, and I am often awed by the level of compassion and commitment I witness among some hospice staff I encounter. Despite this, there are many gaps, the care can be inconsistent, and hospice care is frequently not the appropriate option for people who are encouraged down that path.

Hospice Certifying Physician Medicare Enrollment InformationPalmetto GBA email; 5/6/24Pursuant to our authority under section 6405 of the Affordable Care Act, and as part of CMS' larger strategy to address hospice program integrity and quality of care, certifying physicians, including hospice physicians and hospice attending physicians, must be enrolled in or opted-out of Medicare for the hospice service to be paid. Effective June 3, 2024, (delayed from May 1, 2024) CMS will begin implementing edits to enforce this new rule and will deny hospice claims if the physician entered in the Attending field on the claim is not in the Provider Enrollment Chain and Ownership System (PECOS) as an enrolled or opted-out physician.

How Mass General Brigham provides emergency care at home Becker's Health IT; by Giles Bruce; 5/6/24Somerville, MA-based Mass General Brigham now treats patients needing emergency or urgent care at home. The health system's patients can request referrals to the Home Hospital Emergency Care program through their primary care providers, who decide if patients are stable enough to be treated at home. If they are, a nurse talks to the provider and schedules a home visit, where a paramedic completes a physical exam joined virtually by an emergency medicine physician. Editor's Note: Pair this article with others in today's newsletter: "Stranded in the ER, seniors await hospital care and suffer avoidable harm" (in our Post-Acute Care section), and "[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed framework" (in our International section). 

Early-career physicians working temp roles to 'test drive' practice settings, survey finds Becker's Hospital Review; by Alan Condon; 5/3/24Physicians and advanced practice providers are opting for the flexibility of temporary, locum tenens work in seek of improved job conditions and to relieve burnout, according to an April 23 survey conducted by AMN Healthcare. AMN, the largest provider of healthcare interim leadership and executive search services in the U.S., asked physicians, physician assistants and nurse practitioners who recently have worked locum tenens why they do so. The number one reason, according to 86% of respondents, was a better work schedule, followed closely by addressing feelings of burnout (80%).

National Nurses Week 2024: RN reflects on the state of the profession, calls for change USA Today / Columbia Daily Tribune; by Julia Gomez, USA Today; 5/6/24 Monday, May 6 kicks off National Nurses Week, and it gives folks an opportunity to show their love and appreciation for the people who take care of the sick, injured and dying. From neonatal nurses who help welcome newborns into the world to hospice nurses that provide peace and comfort to their dying patients, nurses play a crucial role in the medical industry. ... Catherine Kennedy, a registered nurse and the Vice President of National Nurses United, told USA TODAY that there needs to be systemic change on the federal level to give nurses the best chance to care for their patients. A study published by the National Library of Medicine states that in 2021, nurses would work an average of "8.2 hours of paid overtime and 5.8 hours of unpaid overtime per week that year — making up the equivalent of more than 9000 full-time jobs." ... 

The power of art in palliative care InSight+, Melbourne, Australia; by Caitlin Wright; 5/6/24 ... Melbourne artist Jeffrey Kelson is known for his thought-provoking portraits, several of which have been exhibited at the Melbourne Holocaust Museum. He believes a portrait is a window into a subject’s heart and mind. However, after being diagnosed with late-stage pancreatic cancer, it wasn’t this style of art that Mr. Kelson was drawn to. As soon as he felt well enough to return to his studio, he started work on a series of colourful collages. “At one point, my wife came into the room and commented on how bright they were and how full of life force. She was surprised that I could create pieces that were so energetic when I felt so ill. I hadn’t really thought about it. I just needed to work,” he told InSight+. ... Palliative care specialist Dr Eric Fairbank was one of Mr Kelson’s art students for several years before Mr. Kelson’s diagnosis. He said Mr Kelson’s approach to his diagnosis has confirmed his belief that the best outcomes of cancer treatment are achieved when they’re complemented by the patient’s own resources of mind, will and spirit. [Click on the title's link to view several of his paintings.]

Highlighting Nurses Week: Tidewell Foundation raising the next generation of hospice nurses Observer; by Tidewell Foundation; 5/2/24 ... Serving Charlotte, DeSoto, Manatee, and Sarasota counties [Florida], the Tidewell Foundation provides the philanthropic support needed to ensure all who need the world-class care of Tidewell Hospice ... funds the only accredited non-profit Nurse Residency program in the United States. Tidewell began its Nurse Residency Program in 2018 to combat the nursing shortage in our region. Now, 6 years later, it is the first hospice to be accredited by the American Nurses Credentialing Center (ANCC), joining a network of 264 nurse residency programs across the nation.

Curricular reform in serious illness communication and palliative care: Using medical students' voices to guide change  Academic Medicine: Journal of the Association of American Medical Colleges; by Jennifer A Reidy, Kate Brizzi, Stephanie H Chan, Hollis Day, Scott K Epstein, Melissa Fischer, Priya S Garg, Anna Gosline, Carolina Jaramillo, Emma Livne, Suzanne Mitchell, Sarah Morgan, Molly W Olmsted, Patricia Stebbins, Isabella Stumpf, Tamara Vesel, Irene M Yeh, Megan E Young, Roberta E Goldman; 5/1/24 Purpose: To gather and leverage the voices of students to drive creation of required, integrated palliative care curricula within undergraduate medical education in Massachusetts, which is lacking in a majority of U.S. medical schools. Conclusions: This study confirms long-standing themes on students' experiences with SIC and palliative care topics, including feeling inadequately prepared to care for seriously ill patients as future physicians. Our study collected students' perspectives as actionable data to develop recommendations for curricular change.