Thursday, January 30, 2014

Providing Palliative Care Training for Providers Can Improve Patient Outcomes

Researchers with Best Practices for End-of-Life Care for Our Nation's Veterans (BEACON) found that providing health care workers with palliative care training led to improved patient outcomes in several areas.

In a study published in the Journal of General Internal Medicine and covered by Fierce Healthcare, researchers conducted a trial intervention at six Veterans Affairs Medical Centers. Training was designed for all hospital providers, and addressed several processes associated with hospice care, including identifying dying patients, delivering the prognosis to patients and families, and applying hospice care best practices to an inpatient environment.

Significant intervention effects were observed for orders for opioid pain medication, antipsychotic medications, death rattle medications, and advance directives. While these changes did improve patient outcomes, the intervention had no significant effect on other areas of treatment, including do-not-resuscitate orders, restraints, intravenous lines, or location of death, according to the study.

Researchers concluded that this type of broadly targeted intervention strategy led to modest but statistically significant changes in several areas, and that if implemented broadly it could improve end-of-life care for thousands of patients in inpatient settings.

In related news, the National Institute of Nursing Research (NINR) recently launched the “Palliative Care: Conversations Matter" campaign to increase the use of palliative care for children with serious illness.

"Initiating palliative care conversations is often hard for both providers and families, especially in the pediatric setting," NINR Director Patricia A. Grady said in a statement. "We hope this campaign and its resources will help ensure that palliative care is considered for every child and family navigating a serious illness."

The campaign's evidence-based materials are designed to help providers initiate palliative care conversations with pediatric patients and their families as soon as possible following diagnosis and to continue these discussions throughout the illness.

The INQRI-funded “Nursing's Specific Contributions to Quality Palliative Care within the Context of Interdisciplinary Intensive Care Practice” explores the relationships between quality palliative nursing care delivered in intensive care units (ICUs) and patient and family outcomes and on how to measure and to improve these outcomes. The purpose of this investigator-initiated study was to examine nursing's specific contributions to quality palliative care provided to patients and their families in the ICU. This interdisciplinary team was led by Lissi Hansen and Richard Mularski.

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