Transcript Slide 1

Hospice Referrals
What is the research question?
PICO: In end-of-life care, are health
professionals with end-of-life education more
likely to result in timely hospice referrals than
those with standard training?
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What is the issue?
 Approximately 35.5% of patients died within
seven days of admission to hospice.
 Effects of short admissions on organizations
• Hospices are cutting back on nurses and
aides.
• Hospice organizations solvency is jeopardized
do to lack of financial gain that appropriate
length admissions bring.
 Patient quality and safety effects of short
admissions:
 Patients and families are missing critical endof-life care.
 Obstacles to Hospice Referrals
 Health professionals :
 See patient death as professional failure.
 Fear that they will destroy patient’s hope.
 Are reluctant to discuss patient prognosis.
References
American Nurses Association . (2010). Scope and standards of nursing practice,
second ed. Washington, DC: American Nurses Publishing
National Hospice and Palliative Care Organization, NHPO ((2013). NHPCO’s
Facts and Figures
Hospice Care in America. Retrieved from:
http://www.nhpco.org/sites/default/files/public/Statistics_Research/2013_Facts_Fig
ures.pdf
Tucker, T. (2009). Culture of death denial: Relevant or rhetoric in medical
education? Journal of Palliative Medicine. DOI: 10.1089/jpm.2009.0234
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Why is research necessary?
 To highlight the crucial need for end-of-life education.
 ANA standard for RNs to improve quality of nursing
practice and patient outcomes
What is a possible
research approach?
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Importance to Nursing
Practice
 If education is proven to increase
referrals, it will allow nurses who are
ideally situated to facilitate
communication about prognosis and
hospice referral among patients, patients'
family members, and hospital staff.
How could this research
change practice?
 Potential to institute an evidence based
standard for education of health
professionals preferably as mandated
continuing education.
Are there potential
1. Investigate current educational opportunities, for:
• Physicians
limitations with a study?
• Nurse practitioners
 Implementation of education
• Physicians Assistants

All
disciplines
not
being
receptive.
• Registered Nurses
• Medical Social Workers, etc.
2. Choose an organization with known referral statistics
for test participants.
• A large medical system such as Spectrum Health
would be ideal because of their dedication to patient
improvement and their ability to implement to all levels
of care. (e.g., acute, long term care, home care, etc.)
Cheryl Shapiro RN
3. Institute new or existing educational programs.
4. Compare current and past hospice referral numbers.
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