Understanding Pain Management in Hospice Care Medicine Term Paper (Term Paper Sample)

Understanding Pain Management: Educating Entry Level Nurses About Caring for the Hospice Patient
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Table of Contents
TOC \o "1-2" \h \z \u Chapter 1: Introduction PAGEREF _Toc11581626 \h 3
Background of the Gap in Nursing Education PAGEREF _Toc11581627 \h 3
The Problem Statement in Nursing Education PAGEREF _Toc11581628 \h 4
Description of the Course PAGEREF _Toc11581629 \h 6
Rationale PAGEREF _Toc11581630 \h 7
Chapter Two: Review of the Literature PAGEREF _Toc11581631 \h 7
Ten Credible Sources PAGEREF _Toc11581632 \h 7
Literature Review Synthesis PAGEREF _Toc11581633 \h 8
Best Practice PAGEREF _Toc11581634 \h 13
Recommendation PAGEREF _Toc11581635 \h 14
References PAGEREF _Toc11581636 \h 16
Understanding Pain Management: Educating Entry Level Nurses About Caring for the Hospice Patient
Chapter 1: Introduction
Background of the Gap in Nursing Education
Hospice care ( the term End-of-life care—EOLC is used often) is a form of palliative care (PC) that attends to chronically ill and nearing their end-of-life (EOL) days, that is, at least one year of life, or typically six months of life for health care and legal purposes ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1i260i2rsg","properties":{"formattedCitation":"(Anstey, Powell, Coles, Hale, & Gould, 2016)","plainCitation":"(Anstey, Powell, Coles, Hale, & Gould, 2016)","noteIndex":0},"citationItems":[{"id":5976,"uris":["http://zotero.org/users/4283279/items/3QGEW32M"],"uri":["http://zotero.org/users/4283279/items/3QGEW32M"],"itemData":{"id":5976,"type":"article-journal","title":"Education and training to enhance end-of-life care for nursing home staff: a systematic literature review","container-title":"BMJ Supportive & Palliative Care","page":"353-361","volume":"6","issue":"3","source":"spcare.bmj.com","abstract":"Background The delivery of end-of-life care in nursing homes is challenging. This situation is of concern as 20% of the population die in this setting. Commonly reported reasons include limited access to medical care, inadequate clinical leadership and poor communication between nursing home and medical staff. Education for nursing home staff is suggested as the most important way of overcoming these obstacles.\nObjectives To identify educational interventions to enhance end-of-life care for nursing home staff and to identify types of study designs and outcomes to indicate success and benchmark interventions against recent international guidelines for education for palliative and end-of-life care.\nDesign Thirteen databases and reference lists of key journals were searched from the inception of each up to September 2014. Included studies were appraised for quality and data were synthesised thematically.\nResults Twenty-one studies were reviewed. Methodological quality was poor. Education was not of a standard that could be expected to alter clinical behaviour and was evaluated mainly from the perspectives of staff: self-reported increase in knowledge, skills and confidence delivering care rather than direct evidence of impact on clinical practice and patient outcomes. Follow-up was often short term, and despite sound economic arguments for delivering effective end-of-life care to reduce burden on the health service, no economic analyses were reported.\nConclusions There is a clear and urgent need to design educational interventions that have the potential to improve end-of-life care in nursing homes. Robust evaluation of these interventions should include impact on residents, families and staff and include economic analysis.","DOI":"10.1136/bmjspcare-2015-000956","ISSN":"2045-435X, 2045-4368","note":"PMID: 27329513","title-short":"Education and training to enhance end-of-life care for nursing home staff","language":"en","author":[{"family":"Anstey","given":"Sally"},{"family":"Powell","given":"Tom"},{"family":"Coles","given":"Bernadette"},{"family":"Hale","given":"Rachel"},{"family":"Gould","given":"Dinah"}],"issued":{"date-parts":[["2016",9,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Anstey, Powell, Coles, Hale, & Gould, 2016). At this level, maintaining the quality of life (QOL) and enabling them to have a dignified form of death is the primary focus ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"8NV1EUCT","properties":{"formattedCitation":"(Krau, 2016)","plainCitation":"(Krau, 2016)","noteIndex":0},"citationItems":[{"id":5972,"uris":["http://zotero.org/users/4283279/items/7NND3XTB"],"uri":["http://zotero.org/users/4283279/items/7NND3XTB"],"itemData":{"id":5972,"type":"article-journal","title":"The Difference Between Palliative Care and End of Life Care: More than Semantics","container-title":"Nursing Clinics of North America","page":"ix-x","volume":"51","issue":"3","source":"DOI.org (Crossref)","DOI":"10.1016/j.cnur.2016.07.002","ISSN":"00296465","title-short":"The Difference Between Palliative Care and End of Life Care","journalAbbreviation":"Nursing Clinics of North America","language":"en","author":[{"family":"Krau","given":"Stephen D."}],"issued":{"date-parts":[["2016",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Krau, 2016). ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0UDyKHYe","properties":{"formattedCitation":"(Lippe, Volker, Jones, & Carter, 2017)","plainCitation":"(Lippe, Volker, Jones, & Carter, 2017)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":5984,"uris":["http://zotero.org/users/4283279/items/KNKY6UBR"],"uri":["http://zotero.org/users/4283279/items/KNKY6UBR"],"itemData":{"id":5984,"type":"article-journal","title":"Evaluating End-of-Life Care Education Within Nursing Programs: A Method for Targeted Curriculum Evaluation","container-title":"Journal of Hospice & Palliative Nursing","page":"266","volume":"19","issue":"3","source":"journals.lww.com","abstract":"Many nurses report feeling ill prepared through their formal education to competently care for dying patients and their families. These deficits signal a need for curricular reform; however, current practices in the provision of palliative and end-of-life (EOL) care education must first be systematically evaluated to guide these reforms. This article will share the findings of a pilot study in which the context, input, process, and product evaluation model was used to guide a detailed evaluation of palliative and EOL care education within a baccalaureate nursing program. Critical aspects of palliative and EOL care education were identified from a decomposition of the End-of-Life Nursing Education Consortium (ELNEC) core curriculum. From the decomposition, a new instrument was developed and completed by nursing faculty members teaching in 1 baccalaureate program. Faculty members identified the ELNEC topics that were taught, the courses within which the content was provided, and the associated teaching methods used. Overall, 95.3% of ELNEC core curriculum content was included in the program; however, great interinstructor variability was noted. Clinical conference discussion/debriefing and lecture were most frequently used to teach ELNEC content. The content was addressed throughout the curriculum, particularly in ethics and aging didactic courses. Implications of the findings for future educational research are discussed.","DOI":"10.1097/NJH.0000000000000341","ISSN":"1522-2179","title-short":"Evaluating End-of-Life Care Education Within Nursing Programs","language":"en-US","author":[{"family":"Lippe","given":"Megan"},{"family":"Volker","given":"Deborah"},{"family":"Jones","given":"Terry"},{"family":"Carter","given":"Patricia"}],"issued":{"date-parts":[["2017",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Lippe, Volker, Jones, and Carter (2017) highlighted that a significant proportion of patients receive hospice care through Medicare benefits, a program that provides specific criteria that the patient must meet to receive care. Nonetheless, the primary aim of hospice care is to manage pain and relief symptoms among patents ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hDA6qzHq","properties":{"formattedCitation":"(Cagle et al., 2015)","plainCitation":"(Cagle et al., 2015)","noteIndex":0},"citationItems":[{"id":6007,"uris":["http://zotero.org/users/4283279/items/WUUDKCUP"],"uri":["http://zotero.org/users/4283279/items/WUUDKCUP"],"itemData":{"id":6007,"type":"article-journal","title":"EMPOWER: An Intervention to Address Barriers to Pain Management in Hospice","container-title":"Journal of pain and symptom management","page":"1-12","volume":"49","issue":"1","source":"PubMed Central","abstract":"Context\nConcerns about pain medications are major barriers to pain management in hospice, but few studies have focused on systematic methods to address these concerns.\n\nObjective\nWe conducted a pilot cluster randomized controlled trial with four hospices to test preliminary efficacy of the EMPOWER intervention which included: hospice staff education; staff screening of barriers to pain management at admission; and discussion about misunderstandings regarding pain management with family caregivers and patients.\n\nMethods\n126 family caregivers (55 intervention; 71 control) were interviewed at two weeks post-admission. If patients survived three months post-admission, caregivers were re-interviewed.\n\nResults\nAt two weeks, caregivers in the intervention group reported better knowledge about pain management (p=.001), fewer concerns about pain and pain medications (p=.008), and lower patient pain over the past week (p=.014); and trended toward improvement in most other areas under study. Exploratory analyses suggest EMPOWER had a greater e...