Literature Review

Four nurses in two weeks assaulted at Essentia Hospitals: Nurses say violence is a consequence of unsafe staffing and inaction Minnesota Nurses Association, Brainer, MN; Press Release; 10/28/25Nurses with the Minnesota Nurses Association (MNA) are once again outraged and deeply concerned after two more violent assaults on nurses at Essentia Health. A nurse at Essentia Health St. Joseph’s Medical Center in Brainerd was attacked by a patient last Thursday, followed by another assault at the same facility over the weekend. The latest incidents come less than two weeks after two nurses were injured at Essentia Health St. Mary’s Medical Center in Duluth. Four nurses assaulted in under two weeks reflects a dangerous pattern in Essentia facilities—one that nurses have been warning about for years.Editor's Note: Continue reading for preventable actions and red flags, "True safety comes from care-based prevention." These were hospital settings; the home care settings your staff and volunteers enter provide much higher risks with less control. Ask your direct care staff for examples of professional situations that were unsafe. Office-based leaders, you might be surprised. Examine your workplace violence policies, procedures, trainings, incident reporting, and follow-up.

Engaging community health workers in Advance Care Planning  Hospice News; by Jim Parker; 10/24/25 Three organizations have developed an advance care planning training program in Illinois for community health workers that could potentially be adapted for other states. The seeds for the project were planted when the Illinois Public Health Association (IPHA) was awarded a grant by the Health Resources & Services Administration (HRSA). IPHA proceeded to engage the Illinois Hospice & Palliative Care Organization (IL-HPCO) and the HAP Foundation as subject matter experts to help develop the curriculum, as well as the education company Hospice Media, which filmed and designed the modules and workbooks.

HCA rebrands 35-plus sites in South Carolina Becker's Health IT; by Giles Bruce; 10/16/25 Over 35 sites of care in South Carolina have rebranded under the HCA Healthcare name. The Nashville, Tenn.-based health system said the new names will make it easier for patients to understand that the facilities, which have been part of HCA for decades, are connected. “By consolidating under the HCA Healthcare name, we’re reinforcing our collective commitment to the communities we serve,” said Hugh Tappan, president of HCA Healthcare’s Charleston, S.C.-based South Atlantic Division, in an Oct. 14 news release. ... The new hospital names include: ...

[England] Ambulance team uses advanced ultrasound to help frail patients avoid hospital trips Emergency Services Times; by James Devonshire; 10/16/25 The East of England Ambulance Service (EEAST) is using cutting-edge medical technology to help elderly and end-of-life care patients receive treatment in their own homes, reducing the need for hospital admissions. The service’s advanced practice (urgent care) team has introduced point of care ultrasound (POCUS)—a portable diagnostic tool previously reserved for critically ill patients—to assess bladder and urinary conditions safely and effectively in community settings. Using the handheld Butterfly ultrasound device, paramedics can perform scans and interpret results via software on iPads, allowing for faster and more accurate diagnoses.

Palliative care at the cutting edge: Recent updates in surgical palliative careJournal of Pain and Symptom Management; by Antoinette R Esce, T J Douglas, Elizabeth Gorman, Sophia Tam, Christopher D Woodrell, Ana Berlin; 9/25Surgical patients with serious illness often experience unique clinical trajectories, systems of care, and relationships with providers. In order to meet the needs of this patient population and their care teams, hospice and palliative medicine professionals should be familiar with evolving best practices in surgical palliative care. We present the case of a geriatric trauma patient with a new diagnosis of advanced cancer cared for in a surgical intensive care unit. This example highlights important new developments in defining and supporting the geriatric trauma population, improving and expanding surgical palliative care education, and identifying which seriously ill surgical patients benefit most from palliative care interventions.

With palliative care, earlier referrals mean fewer end-of-life emergency department visits ONS Voice; by Anne Snively, MBA, CAE; 10/15/25 Patients with cancer who are referred to palliative care within one month of death have a mean of 1.17 emergency department (ED) visits, compared to a mean of 0.13 visits for patients referred to palliative care 12 months or more before death—a 160% difference. The data are part of a new study published in JAMA Network Open in July 2025. ... Most of ED visits (47.0%) and EOL ED visits (81.4%) occurred within one month of the palliative care consultation, but the researchers found that both kinds of ED visits “gradually decreased as the time from consultation to death extended.” 

Alzheimer’s Association, Maine Chapter sees largest turnout for annual fundraiser walk WABI-5, Bangor, ME; by Grace Bradley; 10/11/25 For more than two decades, folks have hit the streets of Bangor to help raise money and awareness for Alzheimer’s. On Saturday, Maine’s chapter of the Alzheimer’s Association says they saw the largest crowd yet of about 400 people for their largest annual fundraiser. “We provide free care and support for families and community members walking through this disease, whether it’s Alzheimer’s or other forms of dementia. So what we do enables us to do everything for free. But we also take a portion of that money and put it towards research,” explains Kris Baker, Development Manager of Alzheimer’s Association Maine. Editor's Note: Do you support and partner with the Alzheimer's Association?

Beyond bars: Evaluating end-of-life care and surrogate decision-making for hospitalized incarcerated personsJournal of Palliative Medicine; by Zack Watson, Julie Brown, Abhinav Vyas, Stacey Tillman, Sumi Misra, Rajiv Agarwal, Cheryl Gatto, Allison McCarthy, Mohana Karlekar; 9/25Incarcerated persons (IPs) retain the constitutional right to health care, yet they face unique challenges in accessing palliative care (PC) and designating surrogates, especially when incapacitated. We present two cases of hospitalized IPs with life-limiting illnesses who experienced significant barriers in identifying and engaging surrogates. Both cases underscore the effect of delays in communication with surrogates and restricted end-of-life (EOL) visitation due to correctional policies. These delays limited the delivery of optimal interdisciplinary PC and bereavement support. Despite clear legal guidance under the Tennessee Health Care Decisions Act, misinformation and procedural ambiguity among medical and correctional staff impeded timely and appropriate care.

Decoding code status: Assessing end of life care knowledge in high-risk ED populationsThe Journal of Emergency Medicine; by Shreyans Sanghvi, Jacqueline Furbacher, Thaddeus Puzio, Caroline Ha, Deena Abdelhalim, Mariah Arneson, Alaina Sturkie, Erika Richey, Benjamin Cooper, Samuel Luber; 9/25The National Institute on Aging projects that the U.S. population over age 65 will nearly double by 2050, placing further strain on an already burdened healthcare system. The emergency department (ED) plays a critical role in caring for this vulnerable population, initiating intensive care for approximately 2,000 older adults daily. However, such care often conflicts with the treatment preferences of most Americans; 80% of older adults report a desire to avoid intensive care and repeated hospitalizations at the end of life (EOL). Among 187 patients [surveyed], 84% reported never having heard of code status options (of those who had, 73% were primarily English-speaking) and 83% were unaware of their current code status. Additionally, 74% lacked any ACDs [advance care directives]. Regarding CPR, 80% believed it successfully restarts the heart of sick patients more than 50% of the time, while 83% and 84% had never been informed about what CPR entails or its associated risks, respectively. 

Conspiracy of verticals:  Rethinking healthcare models with Peter Benjamin Teleios collaborative Network (TCN); video/podcast hosted by Chris Comeaux with Peter Benjamin; 10/8/25 In this conversation, Peter Benjamin and Chris Comeaux discuss the impact of COVID-19 on mortality rates, particularly the concept of 'death pull forward' and its implications for Hospice Care. Peter highlights the significant role of assisted living facilities in Hospice days and explores macro trends in healthcare, emphasizing the shift from vertical to horizontal care models. The discussion also covers the evolution of Palliative Care, frail elderly practices, and institutional special needs plans (iSNPs), while stressing the importance of measuring quality of care, particularly in pain management. 

Surgeon perspectives on palliative care: Are we the barrier to better care?The Journal of Clinical Ethics; Sean J Donohue, Baddr A Shakhsheer, Peter Phung, Anthony W Kim, Monica Zell, Sean C Wightman; Fall 25Surgeons face numerous perioperative challenges when caring for patients with life-threatening or chronic diseases. Palliative care has been associated with an average reduction of $3,237 per admission, as well as reduction in emergency department visits, hospital admissions, and hospital length of stay. For patients within the intensive care setting, palliative interventions have shown a 26 percent relative risk reduction in intensive care unit length of stay and overall alignment of patients' and families' goals of care. It remains pervasive in surgical culture that operative intervention and palliation are mutually exclusive and occur sequentially, rather than concurrently. Preoperative palliative care consultations in surgical patients occur less than 1 percent of the time. Preoperative palliative care may serve to help explore, clarify, and document quality-of-life values and preferences, in hopes of better promoting goal-concordant care.

Emergency Department care coordination program for assisted living residents with dementia-A qualitative studyJAMA Network Open; Grace F. Wittenberg, Peter T. Serina, Nichole E. Stetten, Ann Reddy, Ellen McCreedy; 8/25Care transitions to the emergency department (ED) from assisted living centers (ALCs) for residents may include incomplete or inaccurate information during transfer. These transitions can be especially difficult for vulnerable populations, including persons living with dementia (PLWD). In this qualitative study of a care coordination intervention, CCMs [complex care managers] advocated for their patients remotely by filling information gaps, particularly for PLWD and patients in hospice, and perceived that the intervention was associated with improved patient care. CCMs also identified key areas for improvement, such as to increase ED staff awareness of the program and to expand program hours.

Landmark verdict awards over $510 million to Saint Mary’s Health Network Business Wire, Reno, NV; by Noel True and Mark Reece; 10/2/25 In a historic decision with national implications for healthcare, a Washoe County jury awarded Saint Mary’s Health Network, affiliate of Prime Healthcare, over $510 million in damages, including punitive damages, after finding Universal Health Services of Delaware, Inc. (UHS) and affiliated defendants liable for fraud, malice, and oppression in a coordinated scheme against Saint Mary’s Health Network during the height of the COVID-19 pandemic. ... “This verdict delivers a resounding message for all of healthcare: integrity and compassion must guide every decision we make,” said Sunny Bhatia, M.D., President of Prime Healthcare.