...Abstract To present a novice researcher's use of a reflective research diary in the quantitive measure of a mixed methods study and to recommend resulting changes to practice. Reflexivity is often regarded as a useful tool for ensuring the standard of qualitative research. Reflexivity provides transparent information about the positionality and personal values of the researcher that could affect data collection and analysis; this research process is deemed to be best practice. A reflective research diary also allows researchers to record observations about the research process. However, such diaries are rarely used in quantitative research and are even contraindicated. A reflective research diary maintained while conducting a retrospective audit of 150 hospice casenotes. A reflective research diary was written at the end of every research session to keep a detailed history of the research process and to critically reflect on the researcher's thoughts, feelings and observations on the day's work. This paper raises questions about whether reflexivity is appropriate in quantitative research, whether it has the capacity to add something of value or whether it endangers the robustness of the method. The authors consider the place of grounded theory's commitment to reflexivity in this mixed-methods study and discuss whether reflexivity offers any benefits to researcher development. Use of reflexivity had a positive impact on the progress of the quantitative measure...
Words: 3965 - Pages: 16
...HOSPICE NETTAH NDUNGU Texas Tech University Health Science Center School of Nursing Hospice Hospice is a comprehensive, medically directed, team oriented program of care that emphasizes pain control and symptom management rather than curative treatment. It directs acceptance of death as a natural part of life and addresses the psychological and spiritual needs of the patient and family. This paper will outline the history of hospice, the effect it has on healthcare today, why it is important to nursing, how nursing is impacted by the availability of hospice services, and finally, what nursing has done to affect change related to hospice. History of Hospice Hospice was first applied to specialized care for dying patients by Dr. Dame Cicely Saunders, who started working with the terminally ill in 1948 (NHCPO, 2015). Dr. Saunders later created the first modern hospice – St. Christopher’s Hospice in a residential suburb in London. Her approach was later introduced to healthcare professionals and chaplains in the U.S in 1963 during a lecture at Yale University. In 1969 Elizabeth Kubler-Ross contributed to the idea of hospice centered care in her book: On Death and Dying which highlighted the five stages of dying and a plea for home care as opposed to treatment in an institutional setting. In 1978, the United States’ Department of Health, Education and Welfare Task Force acknowledged the hospice concept as a means of providing more humane care for America’s terminally...
Words: 1224 - Pages: 5
...Review of Literature Essay When a person is placed on hospice, it is generally seen as a comfort measure instead of a curative measure (Villet-Langomarsino 2018). Pain management of the hospice patient is of great importance because it is one of the few things that can be done during the end stage of life when treatment of a disease is no longer desired. Pain is a common symptom in health care and should be one of the easiest to treat due to its popularity, but unfortunately it is not. Since pain is so unique to person, assessment and treatment must be custom tailored to each patient. The problem with pain management is its specificity to each person and disease plus the numerous ways to treat it. Without one specific roadmap of treating...
Words: 1783 - Pages: 8
...Interview of a Hospice Chaplin The Duties of a Hospice Chaplin Michell McGill June 25, 2012 BSHS/302 Tami Frye Hospice Care and Hospice Counseling is a growing profession, which is being incorporated in many hospital and doctor’s offices today. Today there are many private companies who provide these services and they employ Chaplains to assist the patient and the families in making many decisions in reference to end of life wishes. There are many misconceptions as to the purpose of Hospices and the services they provide. The Hospice Chaplin can supply services such as emotional comfort, assist with reconciliation, assist with funeral/ memorial service and any other concerns the patients may have. My own misconception was a reason that I felt the need to research and find out more information. There are many ways to interview an agency, telephone calls, personal interview, and email or an investigative interview as a potential client. I choose an email interview because of the work schedule of the Chaplin and our inability to find a convient time for each of us to meet. . Interview of a Human Service Provider Person Interview (and organization) Kimberly Young-Hardin, MDiv, SCC – Providence Hospice Date of Interview Saturday June 25, 2012 Person Conducting the Interview Michell Walter McGill Hello, my name is Michell W...
Words: 1727 - Pages: 7
...JAN DISCUSSION PAPER JOURNAL OF ADVANCED NURSING The use of theory in qualitative approaches to research: application in end-of-life studies Hung-Lan Wu & Deborah L. Volker Accepted for publication 24 July 2009 Correspondence to D.L. Volker: e-mail: dvolker@mail.nur.utexas.edu Hung-Lan Wu PhD RN Nursing Instructor Meiho Institute of Technology, Pingtung, Taiwan Deborah L. Volker PhD RN AOCN Associate Professor The University of Texas at Austin School of Nursing, Austin, Texas, USA W U H . L . & V O L K E R D . L . ( 2 0 0 9 ) The use of theory in qualitative approaches to research: application in end-of-life studies. Journal of Advanced Nursing 65(12), 2719–2732. doi: 10.1111/j.1365-2648.2009.05157.x Abstract Title. The use of theory in qualitative approaches to research: application in end-of-life studies. Aim. This paper is a report of an analysis of the use of theory in qualitative approaches to research as exemplified in qualitative end-of-life studies. Background. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end-of-life studies is used to illustrate application of theory to study design and findings. Data sources. A review of theoretical literature was carried out, focusing on definitions...
Words: 9578 - Pages: 39
...Providing Good Care to Dying Patients: Paper 2 Jaime Holtgrewe Chamberlain College of Nursing NR 449 Evidence Based Practice February 2013 Clinical Question In my group, the focus of research is based on the following clinical question: What are the best practices for end of life care? Within the group, research is driven to focus on enhancing care for end of life patient, including collaboration with physicians and surrogate decision makers or a power of attorney (POA), as well as pain management policies. However, all aspects of care for end of life patients are taken into consideration when determining which facet is most important. The group’s research consists of quantitative and qualitative articles focusing on transitioning to hospice programs, new measures of care, acceptance of death and experience of caregivers for the dying patient. According to the Journal of Health Politics, Policy & Law (2008), three of every four Americans do not fear death as much as they fear being in pain at the time of death. End-of-life care can be a challenge requiring the full range of a family physician's skills. Significant pain is common but is often undertreated despite available medications and technology. Physicians must overcome their own fears about using narcotics and allay similar fears in patients, families and communities. Drugs such as corticosteroids, antidepressants and anticonvulsants can also help to alleviate pain. A considerable amount of research has compiled...
Words: 1438 - Pages: 6
...palliative care patients?” Regina Nelson Governors State University Abstract Palliative Care Nurses are at risk of experiencing stressful situations related to symptom management and death. The aim of this paper is to critically examine the current stress nurses face caring for Palliative Care patients. Four Nursing Journals and one Psycho-Oncology were reviewed. There was strong evidence to support that nurse’s experience stress caring for Palliative care patients. Common concerns in the first study were caring for a dying patient; personal level, comfort of the patient, and mediating between patient and family. The second study reported physical and emotional health consequences for nurses who provide hospice and palliative care over extended periods of time. The third study of nursesreported job satisfaction, stressors, coping strategies, and support. The fourth study nurses had 10 themes that conceptualize their work that may enable palliative care workers to remain resilient and effectively buffer or moderate stressful effects. The fifth study reported routinization of care, lack of nursing staff’s availability for emotional engagement, frequent interruptions, quiet afternoons, upbeat and positive culture, and a matter of fact attitude surrounding death and dying ,were all the behaviors that “being with” could not create. Although the report showed nurses able to cope by not “being with” the overall impact is stress related to caring for Palliative care patients. Although...
Words: 1898 - Pages: 8
...organization chosen is the E. Carlton Powell Hospice Center, which provides care within the center for patients who have been given 6 months or less to live and are not able to remain in their homes. Apart from the hospice center they also have a home care agency that provides care for patients that remain in their home or in nursing facilities. This paper will discuss the vision, mission, how it is governed and staffed, the stakeholders and their influences on the organization, marketing strategies and importance, values of diversity, and any environmental trends in which they are faced. Mission and Vision The Community Home Care and Hospice provides care within the Carolinas and is the largest provider. The agency was developed in 1995, by the Carrolton Management Corporation. The agency has grown in response to the increase in admissions, the 24/7 care, and the efforts of personal care. The foundation is non-profit 501 © 3 organization. The mission and visions of the agency is: “As a charitable wing of Community Home Care Hospice, the Community Hospice Foundation raises funds to support the crusade against life-limiting conditions by contributing to community awareness and education; scholarships and research; and programs that engage in the practical ministry of indigent care while honoring those we serve and memorializing those for whom we have cared. Community Hospice is committed to providing supportive, palliative, and loving care to terminally ill clients and their...
Words: 1131 - Pages: 5
...organization. Statistics can be used to measure just about anything within a company. Any chosen topic within an organization could have a statistical study done. Specific people within an organization are those that do the studies and post results of the statistics to inform other people within the organization. I work for a hospice organization that is non-profit and I am sure that they are constantly doing studies and tracking statistics of the patients and families that we provide care for daily. This paper will show some possible ways that this hospice organization can use descriptive and inferential statistics. Descriptive Statistics Descriptive statistics is using graphs to describe raw data from research and studies (Bennett, Briggs,& Triola, 2009). One area that we use descriptive statistics and that I can look at deals with patient and family satisfaction. Hospice surveys the patients and the patient’s families that we have taken care of and obtains feedback about the experience they had with hospice. Oftentimes this information comes from the family members because the patients usually pass away before we get this information. This is done with each home care and each inpatient unit that we have. The company takes the feedback for three months and comes up with the mean for those three months to let us know how we are doing in this area. One of the reasons this is done every three months is that sometimes the census is low and there may not be as much data for one month. We...
Words: 1005 - Pages: 5
...Health care as an industry exists to serve its stakeholders in the safest, most effective and efficient manner; but each organization type and company function differently. Organizations share some similar functionalities and regulatory requirements that provide a path for them to follow. The regulatory requirements demand compliance and a standard performance level creating a need for specialized monitoring and accreditation to support quality improvement on numerous levels. Communication is a key component of the process an organization has adopted to maintain compliance, meet standards and regulatory requirements, and maintain the company’s vision and mission. The process commands the role of risk-management to supervise safety functions and quality-management to supervise the stakeholder satisfaction with the services provided in all aspects. Differences and similarities in functionality for each organization or company runs parallel in the goal of safety and satisfaction through monitoring, improving, and communicating to meet regulatory and compliance requirement standards. Similarities and Differences These organizations share many similarities and yet there are differences amongst the five types of organizations chosen; hospitals, emergency services, assisted daily living, home health care, and diagnostics or laboratory facilities. Let us take two, the difference between home health care and assisted daily living are that one may require a higher level of care deemed...
Words: 3228 - Pages: 13
...American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care Elizabeth Joy Gifford University of San Francisco, lgiffman1@aol.com Follow this and additional works at: http://repository.usfca.edu/dnp Part of the Nursing Commons Recommended Citation Gifford, Elizabeth Joy, "The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care" (2009). Doctor of Nursing Practice (DNP) Projects. Paper 14. This Project is brought to you for free and open access by the Theses and Dissertations at USF Scholarship Repository. It has been accepted for inclusion in Doctor of Nursing Practice (DNP) Projects by an authorized administrator of USF Scholarship Repository. For more information, please contact zjlu@usfca.edu. COMPREHENSIVE EXAM 2 Section I: Introduction Statement of the Problem Although 60% of African Americans in the United States have stated that they would want hospice care when they are dying (AARP, 2003), they only comprise 8% of all hospice enrollees (NHPCO, 2007), despite the fact that they represent 13% of the total population in this country (U.S. Census Bureau, 2008). In fact, hospice care in this nation has always been underutilized by African Americans (Connor, Elwert, Spence, & Christakis, 2008). In the San Francisco Bay Area, among Medicare-certified hospice agencies that submit data to the State of California, only 2% of all the hospice enrollees...
Words: 17954 - Pages: 72
...Vulnerable Population and Self-Awareness Paper NUR/440 – Health Assessment and Promotion For Vulnerable Population 12 December 2011 Vulnerable Populations and Self Awareness Introduction This paper is a study of the vulnerable population of the elderly in the United States and will discuss the mindfulness of this author’s personal biases, attitudes, and conceived stereotypes regarding this population. The patient chosen as an example for this paper is Norma James from the University of Phoenix “neighborhood”. Mrs James is a widow who’s vulnerability relating to health care will be compared with information gathered through research and applied to the elderly population and those with chronic illness. The vulnerabilities faced by Norma will be a realistic representation of the challenges associated with this population. Elderly Patients with Chronic Illness Despite the efforts of healthcare providers and various organizations across the United States to reduce or eliminate disparities within vulnerable healthcare populations, significant disparities continue to cause limited access to healthcare. This limitation poses risk to populations such as elderly and those living in poverty. The health domains of vulnerable populations can be divided into 3 categories: physical, psychological, and social. Those with physical needs include the elderly, chronically ill and disabled, chronic medical conditions include respiratory diseases, diabetes, hypertension, dyslipidemia...
Words: 1046 - Pages: 5
...Ryan Somma Information Systems Proposal for XYZ Hospice Table of Contents I. Organization Environment and Requirements......................................3 A. Hospice Care...................................................................................................3 B. Assumptions....................................................................................................3 II. Inputs and Outputs...........................................................................................5 A . Inputs.............................................................................................................5 B. Outputs ...........................................................................................................5 C. Distributed Objects..........................................................................................6 III. System Hardware ...........................................................................................7 A. Client Systems ................................................................................................7 B. Peripherals ......................................................................................................8 C. Server..............................................................................................................8 IV. Software .............................................................................................................9 A. Operating System........................
Words: 4765 - Pages: 20
...7 Finance Wyse………………………………………………………………………………………………………7 Personal Experience & Advantages/Disadvantages…..……………………………………….8-9 Cost Analysis ………………….…..……...............……………...…………………………………………….10 IT Requirement’s & Conclusion………………………….…………………………………....…….…...11 Works Cited………………….…..…………………………………………..........................................12 Executive Summary HealthWyse is an electronic software company that offers three lines of service to homecare organizations including home health, hospice and private duty. The platform provides secure mobile access to scheduling, documentation and billing functions. The program focuses on increasing agency’s revenue, reducing adverse events and promises to streamline homecare services. The array of features HealthWyse offers is ideal for homecare because it offers relevant tools for homecare providers while staying compliant with HIPPA. Hospice providers benefit from using the Chronic Care Management component because they are able to measure and report treatment outcomes, analyze cost and follow best practice guidelines. HealthWyse’s EMR has helped agencies increase revenues by 10%, efficiently manage workflows and shorten revenue...
Words: 3033 - Pages: 13
...Gloria Vheremu ACC 444 Honors Contract Fraud in the healthcare system EXECUTIVE SUMMARY The purpose of this research is to learn about fraud cases that have been happening in the healthcare system for the past few years, and how those fraudulent acts were pioneered and executed. The main focus will be on three of the many pillars that make fraud a reality fraud – committing, concealing and detecting; that is; how the fraudulent was committed, how the perpetrator concealed it and how it was detected by the relevant authorities. Focusing on these three areas gives us the opportunity to take an in-depth look into the loopholes that are making it easy for perpetrators of fraud to be able to commit and conceal fraud and how their actions were detected. The paper will focus on only three of the many cases that made the topic of fraud in the healthcare a force to reckon from 2013 to 2015. These cases include a psychiatrist from Chicago, Lloyd Torrez who was found guilty of defrauding insurance companies; Empowerment Non-Emergency Medical Transportation, Inc. an enrolled Medicaid provider being led by its owner, Ms. Shorter, which was defrauding the Indiana Medicaid; and Paula Cluding, owner of Prairie View Hospice in Oklahoma who provided millions of dollars’ worth of fraudulent claims to the federal Medical Care program. INTRODUCTION Fraud is deliberate deception to gain unfair and unlawful gain from an act. It is both civil and criminally wrong, and the people who...
Words: 1936 - Pages: 8
