Nurse Practitioner-Based Models of Specialist Palliative Care at Home: Sustainability and Evaluation of Feasibility

Bookbinder, Marilyn; Glajchen, Myra; McHugh, Marlene; Higgins, Phil; Budis, James; Solomon, Neva; Homel, Peter; Cassin, Carolyn; Portenoy, Russell K.

doi:10.1016/j.jpainsymman.2010.04.011

Cited by 31 publications

(28 citation statements)

References 12 publications

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“…Such measures might include standardized team-family meetings to clarify goals of care, development of triggers for palliative care consultation, adherence to established professional EOL care guidelines, proactive consultation of clinical social workers and chaplains, and promotion of generalist palliative care competencies across all disciplines. [58][59][60][61][62] For patients who cannot leave the hospital, teams should be identifying ways to make inhospital care feel more peaceful and dignified (e.g., 24-hour family access, private hospital rooms) and developing policies to ensure high-quality EOL care in the acute care setting (e.g., protocols for ventilator withdrawal and palliative sedation).…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Higgins

Garrido

Prigerson

2015

Journal of Palliative Medicine

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Background: Cancer caregivers are key stakeholders in the final weeks of life and in bereavement. Research has highlighted end-of-life (EOL) factors important to caregivers, as well as factors contributing to caregiver mental health and bereavement outcomes. There has been limited data on factors predicting caregiver perceptions of quality of EOL care. Objective: This study's purpose was to identify modifiable predictors of caregivers' Caregiver Evaluation of Quality of End of Life Care (CEQUEL) scores, with the broader aim of informing clinical interventions to improve caregiver impressions of care and subsequent bereavement adjustment. Methods: Study data came from Coping with Cancer I (CwC1). CwC1 investigators interviewed advanced cancer patients and caregivers prior to the patient's death (Wave 1) and reinterviewed caregivers following the death (Wave 2) (N = 275 dyads). The authors identified potential Wave 1 predictors of CEQUEL scores and performed a series of linear regression analyses to identify a parsimonious predictive model using corrected Akaike's Information Criterion (AICc) values. Results: In adjusted analyses, caregivers rated quality of care as poorer when patients died in a hospital (B = -1.40, SE = 0.40, p = 0.001) (B, unstandardized regression coefficient; SE, standard error) or had less than one week of inpatient hospice care (B = -1.98, SE = -0.70, p = 0.006). Whole-person physician care and caregiver religiosity were associated with perceived higher quality of care in unadjusted, but not adjusted, analyses. Conclusions: Findings suggest that place of death and hospice length of stay best predict bereaved caregiver evaluations of quality of EOL care. These findings equip health care providers with modifiable targets to improve caregivers' experience of EOL care and subsequent bereavement.

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Section: Discussionmentioning

confidence: 99%

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Higgins

Garrido

Prigerson

2015

Journal of Palliative Medicine

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“…Although blinding and loss to follow-up unclearly reported but it is not produce risk of bias because the major measurement is cost effectiveness that assess using computerized system. Two studies conducted retrospective controlled studies (Bookbinder et al, 2011) and (Goodwin et al, 2003) have a good quality of study because follow up measurement completely. This study have grade A recommendation also refer to JBI grading system.…”

Section: Results Of Assessment Methodological Qualitymentioning

confidence: 99%

Tinjauan sistematis: Efektifitas Palliative Home Care untuk Pasien dengan HIV/AIDS

Lindayani

Maryam

2017

JKP

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AbstrakAsuhan palitif untuk pasien dengan HIV/AIDS merupakan elemen inti dari asuhan pasien dengan HIV/ AIDS. Asuhan paliatif yang berbasis home care saat ini menjadi elemen penting yang digunakan di berbagai negara. Akan tetapi, tidak ada studi atau tinjauan sebelumnya yang menganalisis efektifitas dari asuhan paliatif yang berbasis home care pada pasien dengan HIV/AIDS. Tujuan dari tinjauan sistematik ini adalah untuk mengevaluasi efektivitas Palliative Home Care untuk pasien dengan HIV/AIDS terhadap nyeri, pengendalian gejala, meningkatkan kualitas hidup, meningkatkan kepuasan asuhan, dan efektivitas biaya. Effectiveness of Palliative Home Care for Patients with HIV/AIDS: A Systematic Review AbstractPalliative care for patients with HIV/AIDS is a core element of HIV/AIDS care, Home-based palliative care is increasingly being used as a key management strategy in many countries. No systematic review has assessed the effectiveness of palliative home care for patients with HIV/AIDS. The objective of this review was to evaluate the effectiveness of home palliative care services for patients with HIV/AIDS on pain and symptoms control, improve quality of life, increase satisfaction of care, and cost effectiveness. Fist an initial limited search of MEDLINE and CINAHL was conducted to screen the exiting studies on palliative home care in patients with HIV/AIDS. These databased were chosen for initial search because that was considered as larger database for health and medical studies. Further searching strategy was conducted by utilizing another databases included: Cochrane Library, UpTodate, Ovid, AIDS care, Journal of palliative care, Journal of palliative medicine. Studies published in English and in years 2000-2016 were included in this review. Data extracted by the reviewers and summarized using the Joanna Briggs Institute (JBI) data extraction tool. We only included 4 studies that met ours inclusion criteria, one studies was randomize controlled trial and three studies were conducted using prospectively control study. The result of this review showed that palliative home care was effective to control pain and symptoms, maintains and improve quality of life, high patients and family satisfaction scores (ranged from 93% to 96%), and more cost effectiveness rather that hospital-based palliative care. Thus, it's imperative to develop palliative home care for patients with HIV/AIDS especially those lived in limited resources country.

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“…7 One research article demonstrated that an NP model of making home visits in an urban setting for palliative care patients demonstrated a decline in adverse symptoms, better compliance to advance care planning, access to community support, and improvement of managing crisis. 20 The NPs did not generate revenue through billing, as it was less than 50% of their salary costs. They did increase Hospice referrals up to 360% within 7 months, which would have supported their position.…”

Section: Resultsmentioning

confidence: 99%

“…Even so, it closed after 2 years from lack of funding. 20 With patients being discharged earlier out of acute care settings, NP led home care is a viable option, especially to the elderly patients and those with more complex needs. Kumar and McKewan reported 21 that the NPs' ability to reduce costs of hospitalization also leads to an increase in patient benefits and overall reduction in health care costs.…”

Section: Resultsmentioning

confidence: 99%

Nurse Practitioners Aiding Frail Elderly Through Home Visits

Duckworth

Repede

Elliott

2013

Home Health Care Management & Practice

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By 2030, one in every eight people will be above age 65 and the worldwide population is projected to increase to one billion. Ages 85 and older are the fastest growing part of the aging population. New reforms like the Independence at Home Act and the Affordable Care Act make home care visits a more viable option. This literature review demonstrates nurse practitioners can provide home care visits as an extension of the medical home model. This will allow frail, elderly patients to receive quality patient-centered care in their home, thereby decreasing emergency room visits, rehospitalization, and workload on office-based primary care providers.

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Nurse Practitioner-Based Models of Specialist Palliative Care at Home: Sustainability and Evaluation of Feasibility

Cited by 31 publications

References 12 publications

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Factors Predicting Bereaved Caregiver Perception of Quality of Care in the Final Week of Life: Implications for Health Care Providers

Tinjauan sistematis: Efektifitas Palliative Home Care untuk Pasien dengan HIV/AIDS

Nurse Practitioners Aiding Frail Elderly Through Home Visits

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