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Patient care is always the hospice nurse's first priority rather than documentation, but in today's legal and regulatory environment, documentation of all aspects of nursing care is critical.
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In a memorandum, President Obama has asked Kathleen Sebelius, secretary of the Department of Health and Human Services, to develop guidance for hospitals participating in Medicare or Medicaid to ensure that patients' advance directives are respected.
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The patient was dying of lung cancer and planned to die at home with his family nearby. Instead, he was raced to the emergency department as he died because his implantable cardioverter-defibrillator (ICD) kept firing an electrical impulse to restore his heart rhythm.
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The policy for deactivation of an implantable cardioverter-defibrillator (ICD) at Hospice of the Western Reserve in Cleveland, OH, clearly spells out the steps and responsibilities of deactivating an ICD's shocking program.
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Although most patient care scenarios can be worked out through careful communication with all those involved, there are certain situations where even greater diplomacy may be required on the part of ethics consultants.
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Compassion & Choices, an advocacy group for "aid in dying" at the end of life, reports that Idaho Gov. Butch Otter, in a letter to the Idaho Senate, encouraged the legislature to revisit a particular bill.
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The value of restoring and maintaining sinus rhythm in patients with atrial fibrillation remains controversial.
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The ACC/AHA guidelines give a class ii b recommendation for surgery in asymptomatic patients if aortic stenosis is very severe (area < 0.6 cm2) and operation risk is low. However, the outcome of this approach vs. following patients until symptoms or left ventricular dysfunction occurs has not been tested.
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Atrial septal defects (ASD) are among the most common congenital heart defect found in the adult population. Although they are often diagnosed and treated in childhood or infancy, some patients survive into adulthood with unrepaired ASDs.
