End-of-Life and Palliative Care Education for Final-Year Medical Students: A Comparison of Britain and the United States

2007 ◽  
Vol 10 (6) ◽  
pp. 1356-1366 ◽  
Author(s):  
James F. Hammel ◽  
Amy M. Sullivan ◽  
Susan D. Block ◽  
Robert Twycross
2018 ◽  
Vol 21 (10) ◽  
pp. 1448-1457 ◽  
Author(s):  
Ambereen K. Mehta ◽  
Salim Najjar ◽  
Natalie May ◽  
Binit Shah ◽  
Leslie Blackhall

2019 ◽  
Vol 8 (7) ◽  
pp. 922
Author(s):  
Daisy J.A. Janssen ◽  
Simon Rechberger ◽  
Emiel F.M. Wouters ◽  
Jos M.G.A. Schols ◽  
Miriam J. Johnson ◽  
...  

Background: Insight into health conditions associated with death can inform healthcare policy. We aimed to cluster 27,525,663 deceased people based on the health conditions associated with death to study the associations between the health condition clusters, demographics, the recorded underlying cause and place of death. Methods: Data from all deaths in the United States registered between 2006 and 2016 from the National Vital Statistics System of the National Center for Health Statistics were analyzed. A self-organizing map (SOM) was used to create an ordered representation of the mortality data. Results: 16 clusters based on the health conditions associated with death were found showing significant differences in socio-demographics, place, and cause of death. Most people died at old age (73.1 (18.0) years) and had multiple health conditions. Chronic ischemic heart disease was the main cause of death. Most people died in the hospital or at home. Conclusions: The prevalence of multiple health conditions at death requires a shift from disease-oriented towards person-centred palliative care at the end of life, including timely advance care planning. Understanding differences in population-based patterns and clusters of end-of-life experiences is an important step toward developing a strategy for implementing population-based palliative care.


2019 ◽  
Vol 25 (11) ◽  
pp. 552-564 ◽  
Author(s):  
Angela Thavaraj ◽  
Karen Gillett

Aims: We aimed to answer the question: what is the evidence that post-registration palliative care education for nurses improves practice? Background: The 2008 End of Life Care Strategy emphasised the need for a workforce equipped to provide high-quality end-of-life care for patients and their families. As registered nurses are the healthcare professionals spending most time with patients and families at the end of life, associated policy documents stress the importance of educating nurses to equip them with the necessary knowledge and skills to provide effective care. Despite education being a consistent recommendation, the ability of education to influence nursing practice is uncertain. Methods: We undertook a systematic review of literature using Joanna Briggs Institute Methodology for Mixed Methods by searching the Medline, Embase and CINAHL databases between January 2006 and December 2018. Findings: Ten studies met the inclusion criteria, seven contained quantitative data. Six demonstrated improvements in outcome measures, but not all results were statistically significant. Most quantitative data related to self-reported measures of confidence. Six studies contained qualitative findings that were categorised into themes: confidence, practice change, skills and proactivity. Conclusion: Little research exists exploring the impact of post-registration palliative care education for nurses. Existing outcome measures do not clearly demonstrate changes to end-of-life practice. Research is suggested to establish links between self-reported confidence and improvements to practice. Evaluation of the impact on practice should be an integral component of end-of-life education initiatives.


2012 ◽  
Vol 28 (4) ◽  
pp. 252-258 ◽  
Author(s):  
Aleksandra Korzeniewska-Eksterowicz ◽  
Bogna Kȩdzierska ◽  
MƗSgorzata Cynker-McCarthy ◽  
Łukasz Przysło ◽  
MƗSgorzata Stolarska ◽  
...  

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 142-142
Author(s):  
Sarah Slater ◽  
Kathleen Doyle

142 Background: The WHO and the Worldwide Palliative Care Alliance have published findings that only 10% of the 20.4 million people who need palliative care currently receive it. A major barrier to meeting that need is insufficient education of healthcare workers in palliative care. Over the last decade, palliative care has attracted significant interest from the government of Belarus, with the first adult hospice founded in 2005 and introduced palliative care into the National Healthcare Law in 2013. However, the country faces a shortage of healthcare providers trained in palliative care. We report on the experience of developing and implementing a palliative care curriculum in Belarus. Methods: We first conducted a needs assessment that examined physician knowledge of and attitudes toward palliative care, the legal status of palliative care, drug availability, and other topics. We utilized past in-country experience, a literature review, a questionnaire, and interviews with Belarusian colleagues. Based on the needs assessment, we developed, modified, and translated a 25-lecture curriculum that was comprehensive, at an adequate difficulty level, and culturally appropriate. A team of four clinicians taught the curriculum in Belarus over to an audience of physicians, and healthcare administrators. Results: The course was well-received—participants were satisfied, reported a better understanding of palliative care, and improved their skills and confidence in managing symptoms and discussing prognosis. Conclusions: We have continued our collaboration with our Belarusian colleagues. New government policies and have passed which promote palliative care. We subsequently held a web-based teleconference with members of the Ministry of Health as well has medical education administrators in Belarus to discuss the structure of palliative care programs in the United States and our model of palliative care education. A second in-person palliative care education workshop for both physicians and nurses is being planned for the fall of 2015. We hope that our experience provides encouragement and resources for the continued promotion of palliative care education and development worldwide.


Author(s):  
Sriram Yennurajalingam

For the provision of palliative care in the hospice setting in the United States, Medicare covers any care that is reasonable and necessary to manage palliative and hospice care at end of life. To be eligible for this Medicare hospice benefit, a beneficiary must be entitled to Medicare Part A and be certified by a physician to have a life expectancy of 6 months or less if the illness runs its expected course. Medicare covers medications, nursing care, and medical services including care by a physician, physical therapy, social work. This chapter briefly reviews the various aspects of the Medicare hospice benefit.


2014 ◽  
Vol 6 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Howard L. Saft ◽  
Paul S. Richman ◽  
Andrew R. Berman ◽  
Richard A. Mularski ◽  
Paul A. Kvale ◽  
...  

Abstract Background Intensive care unit (ICU) use at the end of life is rising. Little research has focused on associations among critical care fellows' training, institutional support, and bedside tools with ICU use at the end of life. Objective We evaluated whether hospital and critical care medicine program interventions were associated with ICU use in the last 6 months of life for patients with chronic illness. Methods Our observational, retrospective study explored associations between results from a survey of critical care program directors and hospital-level Medicare data on ICU use in the last 6 months of life. Program directors evaluated quality of palliative care education in their critical care fellowships and reported on the number of bedside tools and the presence or absence of an inpatient palliative care consultation service. Results For the 89 hospitals and 71 affiliated training programs analyzed, there were statistically significant relationships between 2 of the explanatory variables—the quality of palliative care education and the number of bedside tools—in ICU use. Each level of increased educational quality (1–5 Likert scale) was associated with a 0.57-day decrease in ICU days, whereas, for each additional, evidence-based bedside tool, there was a 0.31-day decrease. The presence of an inpatient palliative care program was not a significant predictor of ICU use. Conclusions We found that the quality of palliative care training in critical care medicine programs and the use of bedside tools were independently associated with reduced ICU use at the end of life.


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