Literature Review

Chicago area nurse gets 2 years in prison for stealing morphine from sick patientsCBS News TV 2, Chicago; by Acacia Hernandez; 4/4/24A northwest suburban nurse was sentenced in court on Thursday to two years in federal prison for stealing morphine from her patients, some of whom were terminally ill. Sarah Diamond, 31, of Woodstock, was accused of targeting the most vulnerable, including hospice patients living out their final days. In 2021, she removed liquid morphine from bottles that had been prescribed to at least five hospice patients and replaced it with saline. Prosecutors said she took the medication for her own personal use.

Study shows strong social ties may ease the way for older adults in life's final chapter Medical & Life Sciences, by Vijay Kumar Maleus; 4/4/24  Study Results: ... The analysis revealed that higher levels of loneliness were significantly associated with increased odds of experiencing anxiety, sadness, and pain in the last month of life, suggesting a pivotal link between social isolation and end-of-life symptomatology. Furthermore, marital status and the receipt of personal care were predictors of dying in a hospital, pointing to the influence of social support structures on the location of death. Interestingly, a larger social network was correlated with a higher likelihood of receiving hospice or palliative care, highlighting the potential benefits of broader social connections. 

Qualitative analysis of initial palliative care consultations in amyotrophic lateral sclerosis Journal of Pain and Symptom Management; by Christine L Watt, Ian C Smith, Jill Rice, Rebekah Murphy, Ari Breiner, Maria Duff, Danica Nogo, Shirley H Bush, Susan McNeely, Usha Buenger, Belinda Zehrt, Jocelyn Zwicker; 4/2/24, online ahead of print Background: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs.

Neuropsychiatric effects associated with opioid-based management for palliative care patients

RNs are moving away from home health and hospice, federal survey reveals McKnights Home Care, by Adam Healy; 4/2/24 Though the number of registered nurses continues to grow, fewer are working in home healthcare and hospice compared to years past, according to the latest national sample survey collected by the Health Resources & Services Administration. In 2018, there were 179,509 RNs working in home health and hospice, representing about 6% of the nursing workforce, according to an earlier national survey. HRSA’s latest count estimated that there were 173,808 RNs in home health and hospice in 2022, or only 5% of the workforce. 

Blue Shield's Palliative Care Program wins national recognition for improving lives Blue Shield California; 3/28/24 During the first quarter of this year, the Journal of Palliative Medicine published results of a study entitled “Cost and Utilization Implications of a Health Plan’s Home-Based Palliative Care Program” from leaders at Blue Shield and researchers from West Health Research Institute that garnered attention from industry publications. ...  Major findings from the study were that home-based palliative care delivered to people not yet eligible for hospice reduced their hospital and emergency room use, showed trends towards an increased length of life, and extended the continuum of care for people with serious illness and their caregivers.

Should we be using palliative care for scleroderma? The Medical Republic, by Karina Bray; 4/2/24Almost three-quarters of systemic sclerosis patients could benefit from specialist palliative care, according to Australian research. The first-of-a-kind study, published in Arthritis Care & Research, set out to examine and quantify the need for palliative care to address high symptom burden as an integrated part of systemic sclerosis management. ... “Almost 75% of SSc patients may benefit from specialist palliative care input to manage specific severe symptoms, and the overlapping nature of such symptoms highlights the complex symptom management needs of SSc patients,” the authors wrote. 

[Maine] Senate backs safe staffing bill with aim to increase patient safety, decrease nurse burnout Main Morning Star, by Lauren McCauley; 3/27/24 If passed, Maine would be the second state in the country to institute nurse-to-patient ratios. ... Sen. Stacy Brenner (D-Cumberland), who sponsored the bill, shared with the chamber her experience as a nurse and how the stress of being understaffed can contribute to burnout and what she described as “moral distress.” ... Brenner said the bill accomplishes two goals: increasing patient safety and increasing nurse retention. 

“Personhood,” not “Patienthood”:  Tips on dignity-conserving practice in palliative careIAHPC, by Kim Adzich, MD; 4/1/24 One of Dame Cicely Saunders’ foundational tenets of palliative care is embodied in her words, “You matter because you are you, and you matter until the last moment of your life.” Dignity is the inherent worthiness of being human, of mattering until that last breath. But how do we ensure that we reflect that inherent dignity back to those in our care? Dr. Harvey Max Chochinov, having dedicated decades to researching and teaching dignity-conserving care, ... [offers] a few thoughts on how we can foster that sense of dignity and uniqueness in those we care for as they near the end of life. 

Interruptions: Bad for hospitalists and their patientsThe Hospitalist, by Larry Beresford; 4/1/24More than 10 years ago this magazine published an article by Winthrop Whitcomb, MD, MHM, a pioneer of hospital medicine and co-founder of the Society of Hospital Medicine, warning of the hazards of workflow interruptions for hospitalists, which he labeled a career satisfaction issue for clinicians but a safety and quality risk for their patients. A decade later, the problem has surely gotten worse as hospital financial pressures and staff shortfalls push caseloads higher and job stresses drive burnout and premature retirement for doctors who have been pulled in too many directions in their work. 

Code status discussions; difficult but necessary The Hospitalist, by Mark Menet, MD, MPH; 4/1/24 I thought it was just where I practiced, but it turns out that, in the medical field, we’re really bad about having code discussions, which is a significant issue. When some of my patients revealed that no one had ever asked them about their code status before, I decided to conduct some research on this topic. It turns out that, at most, 41% of patients recall discussions about their code status, however, the 10.3% as documented by another study seems much more accurate.

Pediatric Division - National Coalition for Hospice and Palliative Care National Coalition for Hospice and Palliative Care; 3/28/24The National Coalition for Hospice and Palliative Care’s Pediatric Division represents a multi-disciplinary, volunteer team of pediatric palliative care (PPC) leaders. The Division membership is comprised of representatives from all 14 members of the Coalition, three family advocates, as well as representatives from aligned stakeholder organizations including the American Academy of Pediatrics, American Psychological Association, Association for Child Life Professionals, and the State Coalition Network.