Follow-Through of Palliative Care after Nursing Home Admission

入住疗养院后姑息治疗的后续工作

• 批准号: 8960292
• 负责人: Joan Gleba Carpenter
• 金额: $ 4.09万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8960292
• 关键词: Address; Adherence; Admission activity; Advance Care Planning; Age-Years; Aging; Area; Care given by nurses; Caring; Categories; Clinical Practice Guideline; Code; Communication; Complex; Consult; Continuing Education; Data; Data Analyses; Data Collection; Development; Discipline of Nursing; Elderly; Family; Fellowship; Goals; Grant; Health Services Research; Healthcare; Home Nursing Care; Hospital Nursing; Hospital Planning; Hospitalization; Hospitals; Individual; Inpatients; Interview; Life; Measures; Medical; Medicare; Methods; National Institute of Nursing Research; Nurses; Nursing Homes; Outcome; Pain; Pain management; Palliative Care; Participant; Patients; Perception; Psychosocial Assessment and Care; Public Opinion; Qualitative Research; Quality of Care; Quality of life; RQ2; Recommendation; Recruitment Activity; Rehabilitation Nursing; Rehabilitation therapy; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Research Training; Science; Scientist; Skilled Nursing Facilities; Statutes and Laws; Strategic Planning; Structure; Surveys; Symptoms; Terminal Disease; Training; base; care delivery; career; cost; experience; health care quality; hospice environment; hospital readmission; improved; interdisciplinary approach; interest; palliative; person centered; preference; programs; psychosocial; public health relevance; skills; symptom management

DESCRIPTION (provided by applicant): The long term objective of this research training grant is to prepare the applicant as a nurse scientist in aging and palliative care research. The goal of the fellowship is to obtain competency in qualitative research methods, data collection and analysis, and dissemination of findings. Public opinion research about palliative care reveals that 62% of US healthcare consumers over 65 years of age want access to palliative care if they have a serious illness. Eighty-five percent of residents in nursing homes are over the age of 65. Despite being promoted as an effective method to deliver high quality care to nursing home residents with serious life limiting illness, palliative care is not widely available. This could rsult in unintended emphasis on aggressive rehabilitation over palliative goal oriented care, little acknowledgement of patient's values and preferences for palliative care, and missed opportunities for symptom management including psychosocial and spiritual support. There is limited research that follows patients after a hospital-based palliative care consult and subsequent discharge to a nursing home without hospice support. This research will improve understanding of factors and conditions of care delivery in nursing homes after receiving a palliative care consult during hospitalization and measure patient perceptions of care. The specific aims of this qualitative descriptive study are to: Aim 1) Describe the continuity of patients palliative care plan from the hospital to the nursing home, and Aim 2) Describe the experience of patients admitted to the nursing home following discharge from a hospital with a palliative care consult. Up to thirty participants will be recruited from an inpatient hospital palliative care program with discharge planned to one of two nursing homes for post-hospital care without hospice support. Semi-structured interviews, and chart reviews will be conducted. Iterative data coding and analysis will identify categories and themes to develop a rich description of the experience and outcomes of patients admitted to the nursing home after discharge from a hospital with a palliative care consult. In congruence with the National Institute of Nursing Research, this project seeks improve understanding of outcomes for individuals with serious life limiting illness across care settings and positively impact the quality of life for peple living with serious complex life-limiting illness in nursing homes.

描述（由申请人提供）：这项研究培训补助金的长期目标是准备申请人作为一个护士科学家在老龄化和姑息治疗研究。的目标 该研究金旨在获得定性研究方法、数据收集和分析以及传播研究结果的能力。有关姑息治疗的民意研究显示，62%的65岁以上美国医疗保健消费者在患有严重疾病时希望获得姑息治疗。疗养院85%的居民年龄在65岁以上。尽管被推广为一种有效的方法，提供高质量的护理，严重的生命限制性疾病的养老院居民，姑息治疗并没有广泛提供。这可能会导致非故意强调积极的康复姑息目标导向的护理，很少承认病人的价值观和偏好姑息治疗，并错过了机会，包括心理和精神支持的症状管理。有有限的研究，以下患者后，以医院为基础的姑息治疗咨询和随后出院到疗养院没有临终关怀的支持。这项研究将提高护理提供的因素和条件在疗养院接受姑息治疗咨询住院期间和测量患者的护理感知后的理解。本定性描述性研究的具体目的是：目的1）描述患者姑息治疗计划从医院到疗养院的连续性，目的2）描述患者出院后进入疗养院接受姑息治疗咨询的经验。最多30名参与者将从住院姑息治疗计划中招募，计划出院到两家疗养院之一进行无临终关怀支持的院后护理。将进行半结构化访谈和图表审查。迭代数据编码和分析将确定类别和主题，以丰富描述出院后接受姑息治疗咨询的患者入住疗养院的经验和结局。与国家研究所一致 该项目旨在提高对护理环境中严重生命限制性疾病患者的结果的理解，并积极影响养老院中严重复杂生命限制性疾病患者的生活质量。

项目成果

Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study.

• DOI: 10.4037/ajcc2018293
• 发表时间: 2018-11
• 期刊: American journal of critical care : an official publication, American Association of Critical-Care Nurses
• 作者: Alderden J;Zhao YL;Zhang Y;Thomas D;Butcher R;Zhang Y;Cummins MR
• 通讯作者: Cummins MR

Predicting Pressure Injury in Critical Care Patients: A Machine-Learning Model.

• DOI: 10.4037/ajcc2018525
• 发表时间: 2018-11
• 期刊: American journal of critical care : an official publication, American Association of Critical-Care Nurses
• 作者: Alderden J;Pepper GA;Wilson A;Whitney JD;Richardson S;Butcher R;Jo Y;Cummins MR
• 通讯作者: Cummins MR

Midrange Braden Subscale Scores Are Associated With Increased Risk for Pressure Injury Development Among Critical Care Patients.

• DOI: 10.1097/won.0000000000000349
• 发表时间: 2017
• 期刊: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
• 作者: Alderden J;Cummins MR;Pepper GA;Whitney JD;Zhang Y;Butcher R;Thomas D
• 通讯作者: Thomas D

Hospital Palliative Care Teams and Post-Acute Care in Nursing Facilities: An Integrative Review.

医院姑息治疗团队和护理机构的急性后护理：综合审查。

• DOI: 10.3928/19404921-20161209-02
• 发表时间: 2017
• 期刊: Research in gerontological nursing
• 影响因子: 1.6
• 作者: Carpenter,JoanG