...Hospice Creation of Hospice Hospice care is designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. The term “hospice” ( from the same linguistic root as “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for the weary or terminally ill on a long journey in 1948 (History of Hospice Care, 2012). The name of the physician was Dame Cicely Saunders who treated the terminally ill and eventually went on to create the first modern hospice, named St Christopher’s Hospice, in a residential suburb of London. (History of Hospice Care, 2012). Ms. Saunders introduced the idea of specialized care for the dying to the United States of America during a 1963 visit with Yale University. Her lecture, given to medical students, nurses, social workers, and chaplains, about the concept of holistic hospital care, included photos of terminally ill patients and their families, showing the dramatic differences before and after the symptom control care (History of Hospice Care, 2012). Ownership In 2010, there were over 5000 hospice programs nationwide (Facts and Figures: Hospice Care in America, 2012). The majority of these facilities are freestanding agencies constituting 58 percent of all hospice centers (Facts and Figures: Hospice Care in America...
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...Despite high levels of satisfaction expressed by hospice employees when compared to employees in other sectors of health care, hospice social workers have the lowest job satisfaction compared to other professionals on the hospice interdisciplinary team (Casarret, Spencer, Haskins, & Teno, 2011; Monroe & DeLoach, 2004). Job satisfaction amongst health care employees contributes to the retention or tenure of qualified and experienced employees (Fritzsche & Parrish, 2005; Head, Washington & Myers, 2013; Kobayshi & McCallister, 2013; Miller, 2008). High turnover has been shown to be associated with decreased job satisfaction among direct care hospice workers and has also been shown to compromise quality of care for hospice patients (Dill & Kagle,...
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...delivery of a health information technology tool that will allow healthcare professionals Internet access to schedule the ordering and delivery of DME (durable medical equipment). This electronic ordering system will improve the hospice organization’s efficiency. The consultant’s description of StateServ Home Medical will reveal the program to significantly shift the telephone ordering process to Internet access. That leaves the hospice organization’s nursing staff with more time to mange patient care cases. In the ongoing evolution of adapt technologies, hospice organizations should factor integrated durable medical equipment ordering systems that will serve at enhancing patients’ level of care and lower delivery cost. This latest technology will also serve as a maintenance control function which results in complete and accurate billing procedures that will capture active supply use by patients. StateServe Home Medical network services will allow the hospice organization to continue to work alongside their local durable medical equipment providers and gain access to StateServ Home Medical’s real-time order management and in-depth utilization review reports. StateServ Home Medical’s main focus is serving mainly hospice organizations nationwide. DME (durable medical equipment) ordering technologies will allow the corporate executives opportunities to...
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...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...
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...So, only the patients who don't have CPR were those who had palliative.” ( Participant 1) “We know that palliative should focus in the quality of life and make the quality of life better.” ( Participant 1) The last quote here is an example of the ideal perception of palliative care where PC should be conceive as a care that enhances the quality of life. Other codes also represent the falsifying understanding of PC as hospice or end of life care. “They're mixing it with the hospice…Unfortunately, they combine PC and hospice in SA. There is a special people for hospice and special people for PC.” (Participant 1) In Saudi Arabia both healthcare providers, patients and their family perceived PC as the care of dying people. It is usually mixed with hospice and end of life care. Perhaps this misperception is related to the way that PC is delivered in the Saudi healthcare system. Cultural Aspect and Social Background: Culture refer to the attitude and the beliefs of a particular group of people and how they interact and share these beliefs together. Subthemes involve: Shared family decision-making versus patient’s autonomy, the role of alternative medicine and home remedies. An example of these will be the...
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...MA, MS,§ for the RANDFSouthern California Evidence-Based Practice Center (See editorial comments by Dr. Jean S. Kutner, pp 160–162) The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven of 32 studies addressed this as an outcome; two of the three that compared satisfaction between groups showed a significant difference. Evaluations used many different measures...
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...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 and use of theory in qualitative end-of-life studies published in English between 1990 and 2008...
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...Place matters in the United States. Access to affordable high-quality healthcare depends upon where you live. Throughout rural America, nearly 50 million people face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the healthcare disparities and access concerns that are already elevated in rural communities. High poverty rates and job loss in the current economic recession highlight the challenges of accessing health care and rising health care costs in rural areas. Rates of poverty are higher, with fifteen percent of people in rural areas living below the poverty level compared to twelve percent of people in urban areas. The rural economy is dominated by small businesses, which are struggling as the cost of healthcare continues to skyrocket. In the current recession, the rural economy is losing jobs at a faster rate than the rest of the nation, and loss of jobs can lead to loss of healthcare coverage. In particular, rural communities dependent on manufacturing have lost nearly five percent of their jobs since the recession began. Many rural residents work part-time, seasonally, or for themselves, making them less likely to have private, employer-sponsored health care benefits. Research shows that ninety percent of farmers have insurance coverage;...
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...Health Care Coordination Models: Benefits and Challenges Traci L French Salem International University Abstract: Care coordination refers to several forms of patient care management that is patient- rather than provider-focused and has the end goal of the “Triple Aim”-improved patient experience, improved population health and decreased per capita costs. These goals are achieved by developing healthcare models which promote collaborative care between providers, increase communication between health care entities, actively engage patients in health care and lifestyle choices and rely heavily on health technology to extend provider services, personalize care and monitor quality improvement efforts. The main barriers to care coordination implementation include poor reimbursement for services, difficulties with provider network communications, shortages of trained care coordination personnel and ambiguity in provider roles and responsibility, which can lead to provider accountability issues. When well-established, care coordination models allow patients to form substantive, long-term personal relationships with providers and increase personal accountability for health care choices. These relationships increase compliance with care regimens in the ambulatory setting and decrease costs with overall improvement in patient quality of life. Care coordination refers to several forms of patient care management which is patient- rather than provider-focused and has the end goal of...
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...The Data Are In: Best Home Care Marketing Practices Revealed Part 2 White Paper 06-001 WP06-001 Contents 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Background Participant Agency Characteristics Outcomes Conversion Ratio Areas of Interest Written Marketing Plan Formal Marketing Budget Sales Team Training Specialty Programs Findings Interpretation Conclusion Side Bar: Action Plan for Sales and Marketing Success About the Authors Page 1 Pages 2-3 Pages 3-4 Pages 5-6 Page 6 Pages 6-7 Pages 7-9 Pages 9-10 Pages 11-12 Pages 12-14 Page 14 Pages 15-16 Page 16 Page 17 Page 17 WP06-001 The conclusion of a two-part series, this article provides the first look at the responses from a study evaluating the best marketing practices of home health agencies across the country. In Part 1, we profiled a few exemplary agencies with the goal of describing a set of common attributes that have lead to success. In Part 2 (below), we delve deeper into the component measures by exploring the first industry-specific benchmarks of marketing success! Background With each passing day, sophisticated sales and marketing becomes a more important trait among the industry’s leading providers. Ninety percent of survey respondents indicated that they have experienced increased competition over the last three years. Only 51 percent reported that they had increased referrals over the same period with 33 percent citing decreases. The million dollar question, then, is, “What practices are prevalent and...
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...HOME HEALTHCARE TENCY THOMAS AMERICAN SENTINEL UNIVERSITY HOME HEALTHCARE Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care. More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating, or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications. At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury(Eldercare.gov, 2012). That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state. When purchasing home health care directly from an individual provider (instead of through an agency), it is even more important to screen the person thoroughly. This...
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...Past, Present, and Future Janele Fletcher Interdisciplinary Capstone/480 May 30, 2012 Cheryl Burleigh Title of Paper The purpose of this paper is to reflect on one’s personal and professional lives’ during his or her program study at University of Phoenix. I will reflect on one’s growth while looking at the effects of completing the Human Services degree program of current and future professional goals. In this paper, I will discuss one’s views of learning, influences of personal growth and development including professional competences and career goals. Additionally, this paper evaluates areas of growth of skill orientation of core courses, which includes general education and poses areas of recommendation that can enhance the curriculum at University of Phoenix. Lastly, this paper analyzes the effects completing an undergraduate degree program while giving insight of lifelong learning goals (University of Phoenix, 2012). Assessment of one’s personal and professional growth and development enhances awareness and brings accomplishments to the forefront. Personal and Professional Growth As I reflect on personal and professional growth prior to completion of one’s degree program, I realize that one has been empowered by great deals of faculty and staff at University of Phoenix, which has influenced personal and professional growth. People, places, and things easily deterred me in the past however; since enrollment of one’s degree program, empowerment...
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...Accounting Information for Managers To Make Better Decisions 1 Abstract This paper analysis how the accounting information would support the decision making process. The main goal of an accounting system is to provide financial information about the organization including financial situation and the performance of the organization. The decision makers should know the situation of the organization either by comparing competitors or previous periods’ performance in order to achieve the objectives of the company and this being possible by using accounting information. In addition, this thesis studies the importance of having effective and efficient accounting system to make better decision as it relates to increase the profitability target of an organization. Organizations should replace their weak accounting system in order to ensure that each team member in the Accounts Department is conscious of their role to produce good accounting information (1, Okoli Margaret). The result of this paper describes that providing right information to the right people in time via management reporting to maximize the use of reports in decision-making. 2 Introduction Any organization should survive and excel in the fast paced and ever changing market. We are living in the digital era so information can be found everywhere via websites, databases documents, reports, and emails. However, it’s important to read the historical data-set during decision making process but providing report in quick...
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...Research Proposal Running head: RESEARCH PROPOSAL 1 Research Proposal Kathryn Keiper Duke University School of Nursing Research Methods N307-01 Dr. Carla Gene Rapp Apr 20, 2005 Research Proposal Table of Contents 2 Introduction……………………………………………………………………………….3 Review of the Literature…………………………………………………………………..4 Purpose……………………………………………………………………………………8 Methods……………………………………………………………………………………9 Design and research questions…………………………………………………….9 Sample……………………………………………………………………………..9 Survey instrument……………………………………………………..…………10 Research procedures……………………………………………………………..10 Informed consent and IRB approval……………………………………………..11 Strengths and Weaknesses……………………………………………………………….11 Timeline and Cost Considerations……………………………………………………….12 Conclusion……………………………………………………………………………….13 Concept Model………………………………………………………………..Appendix A Sample Questions……………………………………………………………..Appendix B References……………………………………………………………………………….18 Research Proposal Research Proposal Introduction Intensive care units (ICUs) were designed to provide highly skilled, lifesaving nursing care to viable patients with acute illnesses or injuries. Patients with chronic and/or terminal illness were not expected to be admitted to these units, with the possible exception of acute exacerbations of reversible complications. Patients whose care needs changed from curative to palliative were intended to be transferred out of critical care to patient care environments more suited to end-of-life care. However...
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...Watson's Theory of Human Caring Aubrey Thomas NUR/403 February, 18th 2013 Stephanie Merck Watson's Theory of Human Caring A few weeks ago I was assigned to provide care for Mrs Tevez an 82yrs old female of Spanish origin who spoke very little English. Mrs.Tevez had a cervical fracture that resulted from a fall at home. Her admission to hospital was for immobilization with a cervical collar and bed rest pending possible surgery. She was considered a high risk patient because of the possibility of serious complications from her cervical fracture. It is amazing how a caring moment can have such a remarkable effect on persons who are part of that moment. A caring moment is the human care transaction that takes place as a consequence of the human care process. This occasion is where a contact is established between the subjective world of the nurse and recipient of care. This shared moment has the potential to touch the higher spiritual self or soul, and thus transpersonal human caring may occur. Transpersonal caring relationships consist of connections that embrace the spirit or soul of the other through the processes of full, authentic, caring and healing attention in the moment (Watson, 1988). Transpersonal caring implies that the nurse consciously focuses on self and other within interpersonal exchanges that are grounded in the present moment, while at the same time going beyond the moment and opening to new possibilities. The nurse values the existence of the other's...
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