Literature Review

The Alliance commends introduction of legislation to extend hospice telehealth flexibilities  National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]

Montana House considers bill to put more sideboards on medical assistance in dying NBC KPVI-6, Pocatello, ID; by Darrell Ehrlick; 2/26/25 ... On Wednesday, in a hearing of the House Judiciary Committee that was full of as much testimony as tears, opponents and supporters of medical aid in dying, sometimes called “physician-assisted suicide,” discussed House Bill 637, which would codify requirements for physicians to use the process. ... Demonstrating the often complex political issue that can’t be broken down by party lines, Rep. Ed Stafman, D-Bozeman, who is also a lawyer and rabbi, said he was truly conflicted on the bill, and wondered how Juras, also an attorney, viewed the proposed legislation in light of the state constitution’s right to dignity. ... Testimony from medical professionals ranged from strong support to opposition,  ... [Click here for] Here's what [Montana] House Bill 637 would do ...

Home health patients, caregivers lack understanding of palliative care, researchers find McKnights Long-Term Care News; by Adam Healy; 2/25/25 Home healthcare patients, caregivers and clinicians have significant knowledge gaps surrounding palliative care, which are contributing to poorer health outcomes for sick patients, according to a new study published in Home Healthcare Now. ... Healthcare providers, including home care agencies, are partially responsible for this limited public awareness, according to the researchers. The majority of survey participants agreed that it is the responsibility of doctors and nurse practitioners to inform seriously ill patients about palliative care. However, Medicare policy may be at the heart of this issue, Ashley Chastain, the study’s lead author, said.

North Texas doctor helps parents facing infant loss deal with the unimaginableCBS News - Texas; by Andrea Lucia, Lexi Salazar, Katie Standing; 2/25/25[Background story for parents Yvette and Thoms Ngo upon dealing with the news that their in-utero baby girl Zoe was diagnosed with Trisomy 13, would likely miscarry, or die soon after birth. Dr. Terri Weinman, their neonatologist offered rich palliative care interventions and support.] "When we met Dr. Weinman and her team the first time, she would say things like, 'So, what are we going to do when Zoey is here,' which changed my mindset completely," Yvette Ngo said. ... For the first time, the Ngos began to consider what Zoey's life, short as it might be, could look like. "It made us more comfortable with the situation, I mean as comfortable as you can be," Thomas Ngo said. "She just gave us hope." Zoey was born on April 18, 2024. She met her parents, her siblings and her grandparents. She was baptized. "They made us little crafts and mementos for us to take home, like footprints, really ways to help cherish Zoey's life," Yvette Ngo said. "They took her heartbeat and recorded it for us. Little things that we wouldn't necessarily think of." Zoey even had a chance to go home. But after 36 hours of life, Zoey passed away in her father's arms. The perinatal palliative care Zoey received remains rare. But for families like the Ngos, it provides a small sense of control when it's needed most. "Being able to plan so much in advance and think about all the different scenarios and how we wanted it," Yvette Ngo said. " I think, looking back on our time with Zoey..." "We wouldn't have done anything differently," Thomas Ngo said. Editor's note: Pair this with "Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing students," posted 2/24/25.

ONA Leadership Column: The next level State Nurses Associations - Oklahoma Nurses Association; by Dean Prentice, DHA, MA, BSN; 2/24/25 What is it going to take to raise the leadership ability of your staff to the next level? One of the many roles you play for your staff is encouraging their professional development. ... The future of nursing will require a well-rounded skill set that goes beyond traditional clinical training. Emotional intelligence, cultural competence, data-driven decision-making, ethical leadership, and resilience are all critical to meeting the challenges of tomorrow’s healthcare landscape. By developing these skills, nurses will not only improve patient outcomes but will also contribute to the evolution of the nursing profession, ensuring it remains relevant, compassionate, and effective in an increasingly complex world. 

Leading early conversations about ICD [implantable cardioverter defibrillator] use in end-of-life cancer care  Cancer Network; by Megan Mullins, PhD, MPH; 2/21/25 Earlier and more frequent talks about disabling ICDs with patients receiving end-of-life care and their families may help avoid excessive pain. ... Regarding implantable cardioverter defibrillators (ICDs) in those with fatal cancers, it is critical that patients know what having a device means and how it impacts end-of-life care, according to Megan Mullins, PhD, MPH. CancerNetwork® spoke with Mullins, assistant professor in the Peter O’Donnell Jr. School of Public Health, the Harold C. Simmons Comprehensive Cancer Center, and the Department of Internal Medicine at UT Southwestern Medical Center, about how ICD deactivation prior to end-of-life care could impact clinical practice in patients with advanced cancers. ... She emphasized that device deactivation would allow the body to undergo the natural dying process without unnecessary painful shocks associated with the use of the device.

How OU Health's Professional Practice Model is defining nursing excellence Health Leaders; by G Hatfield; 2/24/25 This model enables [Oklahoma University] OU Health to elevate nursing education, practice, and outcomes, says this CNE. ... Stefanie Beavers, DNP, RN, NEA-BC, chief nurse executive at OU Health, and HealthLeaders Exchange  ... The Concept: A professional practice model, according to Beavers, is an evidence-based practice that aligns organizational values with a framework driven by research and outcomes. The goal is to elevate nursing excellence and patient outcomes, but also to solidify the identity of the organization's teams. The OU Health Nursing Professional Practice Model was developed based on the Joanne Duffy Quality Caring Model, so that the organization could take caring behaviors and integrate them into OU Health’s values.

Who cares for the caregivers? The push for laws to protect nurses’ mental health Medscape; by Jodi Helmer; 2/5/25 ... More than 67% of nurses reported feeling depressed or anxious, and two thirds said they were not receiving mental health support. Nurses cite lack of time and financial resources among the reasons for not seeking treatment, but fears about losing their jobs and the impact on their nursing licenses were also top issues. ... Registered nurses (RN) and advanced practice RN (APRNs) can be required to answer invasive questions about their mental health as part of their state licensure and advanced credentialing applications. The questions can be stigmatizing and could require nurses to submit letters from their healthcare providers addressing their mental health status. ... There is a movement to urge licensing and credentialing organizations to remove invasive and stigmatizing mental health questions from their applications. The National Council of State Boards of Nursing is working on national recommendations ...

Hospices traverse the ‘new twists’ in increasingly complex auditing processes Hospice News; by Holly Vossel; 2/20/25 Auditors are raising new questions around two common issues in hospices’ Medicare claims — documentation supporting patient eligibility and the physician narrative. Program integrity issues and quality concerns have raised the bar of regulatory oversight in recent years, with auditing activity ramping up as more providers undergo multiple audits simultaneously each year. ... Claim denials most frequently occur due to insufficiently documented evidence that demonstrates a patient’s eligibility within the physician narrative explanation, Nowicki stated. Auditors have increasingly required more details to support a patient’s six month terminal illness prognosis, potentially stretching the boundaries of hospice requirements stipulated by the U.S. Centers for Medicare & Medicaid Services (CMS), he indicated. [Click on the title's link to continue reading.]

Improving knowledge, confidence, and skills in perinatal bereavement care through simulation in baccalaureate nursing studentsState Nurses Associations - Kansas State Nurses Association; by Shelby True, MSN, RN; Libby Rosen, PhD, RN, IBCLC; Ashley Seematter MSN, RN; Jeri Harvey & Karly Lauer, MSN, RN; 2/20/25Many baccalaureate nursing programs throughout the United States thread concepts of bereavement and end-of-life care throughout their curriculum. However, a standardized education program for nursing students that increases the knowledge, confidence level, and application of skills a nurse must possess when providing perinatal bereavement care is often absent from the curriculum (Sorce & Chamberlain, 2019).  Perinatal loss can have a profound impact on parents and their loved ones, leading to emotional, psychological, physical, and spiritual trauma that deeply affects the lives of those involved. The nursing care each parent receives at the time of the loss may be remembered for years to come and is crucial to determining the nature of the grieving process (Sorce & Chamberlain, 2019). ... To improve the knowledge, confidence, and skill level of nurses providing perinatal bereavement care, a role-play perinatal bereavement simulation was developed and implemented in two Midwestern universities’ baccalaureate nursing programs in the maternal/newborn courses. Editor's note: Having served our hospice's Pediatrics Team for four years, the grief of parents, grandparents, siblings affected me deeply. I remember vividly a young mom unable to physically leave her baby's body with the hospital's nurse. Gently, we held her baby together. Over the course of about 15 minutes, the mother gradually shifted the weight of holding her baby over to me, before the hardest task of her life--leaving the hospital without her child. (It was Christmas week. I bawled when I got home.) Visiting them at the funeral home and after in their home, I experienced horrible, disenfranchised comments and attitudes from others (especially a local preacher). Leaders: tune into your pediatric hospice and palliative team members. What specialized support and education do they need? And, we never know what personal stories of perinatal bereavement those around us continue to carry. 

800 Geisinger nurses strike: 5 things to know Becker's Hospital Review; by Kelly Gooch; 2/19/25Members of Service Employees International Union Healthcare Pennsylvania began a five-day strike Feb. 17 at Geisinger's Luzerne County facilities in Pennsylvania, union and health system spokespeople confirmed to Becker's. Five things to know:

ViVE 2025: Improving clinical workflows amid workforce shortages HealthTech; by Teta Alim; 2/18/25 As the U.S. braces for a dearth of physicians and nurses, healthcare organizations are transforming processes to attract and retain talent. By 2034, experts have projected, there will be a shortage of between 17,800 to 48,000 primary care physicians. For full-time registered nurses, 2030 projections are even steeper. Healthcare organizations are well aware of these forecasts and have been testing and deploying solutions to improve employee satisfaction and retention and attract new talent. At ViVE 2025 in Nashville, Tenn., industry leaders discussed how improvements supported by artificial intelligence (AI) are offering promising results for streamlining workflows. [Click on the title's link to read this discussion.]

An interview with Clinical Psychologist (retired) Johanne de Montigny, M.A.Ps. ehospice; interview between Dr. Stefanie Gingras and Johnne de Montigny; 2/14/25 Ahead of her February 19, 2025 lecture entitled “What I’ve learned about accompaniment, death and bereavement: 29 years of psychological services at the heart of an MUHC care team (1986-2015)”, part of the McGill National Grand Rounds programme, Johanne de Montigny shared her thoughts with Program Director and palliative care physician Dr. Stéfanie Gingras.Dr. Stéfanie Gingras (SG): How did you first become interested in the field of palliative care?Johanne de Montigny (JdM): It was a very profound and sudden experience where I almost died that guided me in this choice. I survived a plane crash, in which 17 people (out of 24) died. After this event, I asked myself what I was going to do with my life. For me, that meant choosing a profession that would be meaningful. After returning to school to study psychology, I chose to become a palliative care psychologist. After being confronted with sudden death, I wanted to understand how people reacted when they learned that they were going to die, that they still had time, and how to live with it. ... In those moments, I remembered that before I died – because I thought I was going to die – the young flight attendant who, in the space of a minute before the crash, had managed to help us contain the shock and give us some hope. She told us, “Whatever happens, we’re together and we’re going to get through this together.” That one relational minute made all the difference. It enabled us, I believe, to survive psychically before dying physically. She was my first carer just before she died. ... As for the family, what was most striking for me was the realization that the end of life is a time of unparalleled intimacy. Editor's note: This rich life-reflection provides powerful insights in light of many recent plane tragedies.