Caring Beyond Cure: Integrating the Philosophy and Practice of Palliative Care Into a Medicare-Certified Home Health Agency in Rural Hawaii

2.50
Hdl Handle:
http://hdl.handle.net/10755/153416
Type:
Presentation
Title:
Caring Beyond Cure: Integrating the Philosophy and Practice of Palliative Care Into a Medicare-Certified Home Health Agency in Rural Hawaii
Abstract:
Caring Beyond Cure: Integrating the Philosophy and Practice of Palliative Care Into a Medicare-Certified Home Health Agency in Rural Hawaii
Conference Sponsor:Sigma Theta Tau International
Conference Year:2005
Author:Kuehner, Barbara N., BSN, MA, RN, CHPN
P.I. Institution Name:West Hawaii Home Health
Title:Staff Nurse; Nursing Skills Instructor
Co-Authors:Robin L. Seto, MD, CMD, FAACP
Several years ago, the management team of a rural home health agency identified the need to increase staff competency in palliative care. Clinical practice guidelines in palliative and end of life care provided the basis for competency development and practice change. Research utilization and translation of evidence based guidelines into practice are especially challenging in rural areas which are isolated from academic health centers, university-based schools of nursing and centers of health care research. The home care setting presents the additional barrier of a dispersed work force with limited opportunities for peer support, mentoring and coaching. Several strategies were employed to implement clinical guidelines: 1. Management support: In July 2000, the Administrator, VP Operations and Medical Director endorsed the "5 Precepts of Palliative Care" as developed by the Last Acts Task Force and embraced them in the organizations philosophy of care. 2. Education: The entire staff (nurses, nursing assistants, therapists, office staff) completed the EPEC curriculum under Medical Director leadership. (EPCE = Education on Palliative and End of Life Care.) 3. Coaching and mentoring: Interdisciplinary team meetings, RN meetings and individual consultation provided opportunities to discuss and evaluate palliative care interventions. 4. Changes in practice environment: Examples of changes enabling guideline implementation are: revised policy on death in the home which involved local police department; use of CCO-DNR bracelets, which included education of local physicians; relationship with and understanding of Hospice and the Hospice medicare benefit. 5. Monitoring: Outcomes monitored over three years included deaths in home, deaths in hospital, number using CCO-DNR bracelets, number transferring to Hospice and number referred to but denied by Hospice. Data were further evaluated to determine why patients transferred to the hospital for anticipated death and why patients refused transfer to Hospice.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCaring Beyond Cure: Integrating the Philosophy and Practice of Palliative Care Into a Medicare-Certified Home Health Agency in Rural Hawaiien_GB
dc.identifier.urihttp://hdl.handle.net/10755/153416-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Caring Beyond Cure: Integrating the Philosophy and Practice of Palliative Care Into a Medicare-Certified Home Health Agency in Rural Hawaii</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kuehner, Barbara N., BSN, MA, RN, CHPN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">West Hawaii Home Health</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Staff Nurse; Nursing Skills Instructor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bkuehner@hawaii.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Robin L. Seto, MD, CMD, FAACP</td></tr><tr><td colspan="2" class="item-abstract">Several years ago, the management team of a rural home health agency identified the need to increase staff competency in palliative care. Clinical practice guidelines in palliative and end of life care provided the basis for competency development and practice change. Research utilization and translation of evidence based guidelines into practice are especially challenging in rural areas which are isolated from academic health centers, university-based schools of nursing and centers of health care research. The home care setting presents the additional barrier of a dispersed work force with limited opportunities for peer support, mentoring and coaching. Several strategies were employed to implement clinical guidelines: 1. Management support: In July 2000, the Administrator, VP Operations and Medical Director endorsed the &quot;5 Precepts of Palliative Care&quot; as developed by the Last Acts Task Force and embraced them in the organizations philosophy of care. 2. Education: The entire staff (nurses, nursing assistants, therapists, office staff) completed the EPEC curriculum under Medical Director leadership. (EPCE = Education on Palliative and End of Life Care.) 3. Coaching and mentoring: Interdisciplinary team meetings, RN meetings and individual consultation provided opportunities to discuss and evaluate palliative care interventions. 4. Changes in practice environment: Examples of changes enabling guideline implementation are: revised policy on death in the home which involved local police department; use of CCO-DNR bracelets, which included education of local physicians; relationship with and understanding of Hospice and the Hospice medicare benefit. 5. Monitoring: Outcomes monitored over three years included deaths in home, deaths in hospital, number using CCO-DNR bracelets, number transferring to Hospice and number referred to but denied by Hospice. Data were further evaluated to determine why patients transferred to the hospital for anticipated death and why patients refused transfer to Hospice.</td></tr></table>en_GB
dc.date.available2011-10-26T12:15:31Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T12:15:31Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.