2.50
Hdl Handle:
http://hdl.handle.net/10755/165654
Category:
Abstract
Type:
Presentation
Title:
Hope: Home Care Outreach For Palliative Care Education
Author(s):
Borneman, T.
Author Details:
T. Borneman, City of Hope National Medical Center, Duarte, California, USA
Abstract:
Significance: While palliative care principles are prevalent in hospice programs, such care has often not extended into other systems of home care. Nurses spend more time with terminally ill patients than any other member of the health care team. Home care agencies provide extensive care to patients and families facing many physical and psychosocial demands at the end of life. Palliative care education is important to support home care nurses in optimum end of life care as managed care and advanced technology are placing greater demands on home care as the primary setting of care. Many nurses in general home care settings have limited palliative care experience or knowledge. Purpose: The purpose of this NCI funded training project is to improve end of life (EOL) care in non-hospice home care agencies through implementation of a palliative care curriculum. Scientific Framework: The framework for this study is based on the results of a needs assessment survey on end of life issues completed by 134 home care agencies from 1996 to 1997. The framework consists of 5 modules: Overview of Palliative Care; Pain Management; Symptom Management; Communication, Family Caregivers, and Spirituality; and The Good Death. Methods: This project occurs in two phases. Phase I extended the HOPE curriculum to 5 agencies in the Los Angeles area. Phase II disseminates this curriculum to 50 additional agencies drawn from a national pool of applicants. Phase I used a convenience sample of 99 RNs, 26 LVNs, and 28 Home Health Aides (HHA). Methods of data collection included two written surveys conducted pre- and post-intervention (RN/LVN and HHA Home Care Individual Evaluation, RN/LVN and HHA End of Life Knowledge Assessment) and a Chart Audit Tool. Data Analysis: Descriptive and comparative statistics for pre- and post-intervention were used. Findings and Implications: Of the 119 nurses and home health aides, 79 were RNs, 14 were LVNs and 26 were HHAs. The Individual Evaluation tool revealed that RN/LVNs felt least comfortable dealing with cultural issues in EOL care. HHAs felt least comfortable managing death at home. The RN/LVN EOL Knowledge Assessment revealed lowest correct response (35%) when asked the recommended route of administering opioids to cancer patients with pain. Only 24% of HHAs correctly answered the statement regarding judging the patient’s pain by watching for signs of grimacing or moaning. The chart audit revealed no consultation (0%) with chaplains, clinical nurse specialists, or pain specialists. There was no plan for follow-up with family after death, 56% had no Advance Directive and 88% had no documentation as to whether or not the patient had a durable power of attorney. Comparison of pre- and post-scores rating perceived effectiveness demonstrates significant improvement in areas of EOL care (p<.01). These findings represent the need for educating RNs, LVNs and HHAs on better end of life care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHope: Home Care Outreach For Palliative Care Educationen_GB
dc.contributor.authorBorneman, T.en_US
dc.author.detailsT. Borneman, City of Hope National Medical Center, Duarte, California, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165654-
dc.description.abstractSignificance: While palliative care principles are prevalent in hospice programs, such care has often not extended into other systems of home care. Nurses spend more time with terminally ill patients than any other member of the health care team. Home care agencies provide extensive care to patients and families facing many physical and psychosocial demands at the end of life. Palliative care education is important to support home care nurses in optimum end of life care as managed care and advanced technology are placing greater demands on home care as the primary setting of care. Many nurses in general home care settings have limited palliative care experience or knowledge. Purpose: The purpose of this NCI funded training project is to improve end of life (EOL) care in non-hospice home care agencies through implementation of a palliative care curriculum. Scientific Framework: The framework for this study is based on the results of a needs assessment survey on end of life issues completed by 134 home care agencies from 1996 to 1997. The framework consists of 5 modules: Overview of Palliative Care; Pain Management; Symptom Management; Communication, Family Caregivers, and Spirituality; and The Good Death. Methods: This project occurs in two phases. Phase I extended the HOPE curriculum to 5 agencies in the Los Angeles area. Phase II disseminates this curriculum to 50 additional agencies drawn from a national pool of applicants. Phase I used a convenience sample of 99 RNs, 26 LVNs, and 28 Home Health Aides (HHA). Methods of data collection included two written surveys conducted pre- and post-intervention (RN/LVN and HHA Home Care Individual Evaluation, RN/LVN and HHA End of Life Knowledge Assessment) and a Chart Audit Tool. Data Analysis: Descriptive and comparative statistics for pre- and post-intervention were used. Findings and Implications: Of the 119 nurses and home health aides, 79 were RNs, 14 were LVNs and 26 were HHAs. The Individual Evaluation tool revealed that RN/LVNs felt least comfortable dealing with cultural issues in EOL care. HHAs felt least comfortable managing death at home. The RN/LVN EOL Knowledge Assessment revealed lowest correct response (35%) when asked the recommended route of administering opioids to cancer patients with pain. Only 24% of HHAs correctly answered the statement regarding judging the patient&rsquo;s pain by watching for signs of grimacing or moaning. The chart audit revealed no consultation (0%) with chaplains, clinical nurse specialists, or pain specialists. There was no plan for follow-up with family after death, 56% had no Advance Directive and 88% had no documentation as to whether or not the patient had a durable power of attorney. Comparison of pre- and post-scores rating perceived effectiveness demonstrates significant improvement in areas of EOL care (p&lt;.01). These findings represent the need for educating RNs, LVNs and HHAs on better end of life care.en_GB
dc.date.available2011-10-27T12:22:33Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:33Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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