ABSTRACT
The Hospice and Palliative Nurses Association, in conjunction with the Hospice and Palliative Credentialing Center and the Hospice and Palliative Nurses Foundation, organized a Palliative Nursing Summit in Washington, DC, on May 12, 2017. The goal of the summit was to convene leaders from various nursing specialty organizations to develop a collaborative nursing agenda for primary palliative nursing. The work of the summit focused on 3 aspects of palliative nursing: communication/advance care planning, coordination/transitions of care, and pain and symptom management. The meeting objectives were to identify the current state of primary palliative nursing and to identify the greatest opportunities to advance primary palliative nursing within the 3 focus areas. Twenty-six nursing specialty organizations participated in the summit. This article describes the basis for the summit, the data and resources that informed the meeting's participants, the outcomes in each of the 3 categories, and next steps.
Subject(s)
Congresses as Topic/trends , Hospice and Palliative Care Nursing/trends , Advance Care Planning , Communication , Hospice and Palliative Care Nursing/organization & administration , HumansABSTRACT
When undergoing concomitant chemotherapy and radiation therapy for anal cancer, patients often experience significant side effects, including grade 1 or 2 radiation dermatitis, pain, exudate, and diarrhea. This case study presents a grade 3 reaction complicated by complex medical conditions. In addition to an evidence-based skin care treatment and side effect management plan that support patients during this intense period, this article offers creative strategies to provide a cost-effective healing option.
Subject(s)
Anus Neoplasms/therapy , Carcinoma, Squamous Cell/therapy , Chemoradiotherapy/adverse effects , Oncology Nursing/methods , Pain/etiology , Radiodermatitis/therapy , Anus Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Chemoradiotherapy/methods , Follow-Up Studies , Humans , Male , Middle Aged , Pain/physiopathology , Pain Management/methods , Radiation Injuries/diagnosis , Radiation Injuries/therapy , Radiodermatitis/diagnosis , Risk Assessment , Skin Care/nursing , Treatment Outcome , Wound Healing/physiologyABSTRACT
Interruptions in sleep for hospitalized patients have been correlated with decreases in immune function, changes in mental status, and increased stress levels. The purpose of this study was to explore patients' perceptions of their sleep experiences during hospitalization. Structured interviews were conducted with a convenience sample of patients who had spent three consecutive nights in the hospital. Data was analyzed by content analysis; three themes emerged from the data. The findings from this pilot study will lead to further research in nursing practice as it relates to supporting sleep and rest in hospitalized patients.
Subject(s)
Acute Disease/nursing , Hospitalization , Inpatients/psychology , Sleep Wake Disorders/nursing , Sleep , Acute Disease/psychology , Adult , Humans , Nursing Methodology Research , Pilot Projects , Qualitative Research , Sleep Wake Disorders/psychologyABSTRACT
As patients with terminal disease enter into the final stage of their illness, psychiatric symptoms and psychological responses to the disease contribute to overall suffering of both patient and family. Until recently, no nationally accepted guidelines or practices had been established to support assessment and management of this type of suffering. In 2007, the National Quality Forum published A National Framework and Preferred Practices for Palliative and Hospice Care Quality that included a list of preferred practices for assessing and treating symptoms of psychiatric illness, anticipatory grief and psychologic distress prior to death, and bereavement after the death, of the patient. While specialized care may be provided to patient and families in the context of advanced disease, all clinicians involved in palliative and end-of-life care are responsible for having a basic understanding of effectively managing psychologic and psychiatric aspects of this care. Evidence from current literature supports these best practices.
Subject(s)
Hospice Care/standards , Palliative Care/standards , Patient Care Planning/standards , Practice Guidelines as Topic , Terminally Ill/psychology , Bereavement , Consensus , Humans , Professional-Family Relations , Quality of Health Care/standards , Stress, Psychological/psychology , United StatesABSTRACT
Dehydration is a serious acute condition in older adults associated with significant morbidity and mortality. Hypodermoclysis (HDC; the infusion of fluids into the subcutaneous tissue) can provide an alternative to intravenous (i.v.) rehydration of older adults. This article reviews the relevant literature on the use of HDC to treat mild to moderate dehydration in older adults. A comprehensive search of the literature was conducted to identify research reports on the use of HDC to treat dehydration in older adults. Articles published in English during the previous 10 years were reviewed to reflect current standards of practice. One systematic review; two randomized, controlled trials; and six cohort studies were identified and appraised. Only one study was conducted in the United States; the remainder were conducted in Europe, Asia, and Canada. The evidence indicated that HDC is as effective as i.v. rehydration of older adults with mild to moderate dehydration. The literature cites advantages of HDC over i.v. hydration, including the same number of or fewer complications, cost savings, greater patient comfort, and less nursing time to start and maintain the infusion. It remains unclear from the literature why HDC is used infrequently in the United States.
