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One of the most attractive aspects of hospice and other types of home health nursing is the constantly changing job; no two days are exactly alike. That same diversity also raises issues that hospital-based nurses don't face.
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An ethics service or ethics committee will look different in each hospice and home health agency, because the program should be geared to meet the specific needs of the agency, says Sigrid Fry-Revere, PhD, JD, medical ethicist and president of the Center for Ethical Solutions in Lovettsville, VA.
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Medical ethics is not the typical topic of free community health discussions, but the staff at Winona (MN) Health's Home Care and Hospice, as well as Senior Services, have found a welcoming audience for the talk.
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Recent research indicates that blacks and Asians with terminal cancer use end-of-life services less frequently than do whites and Hispanics.
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More than 1.4 million Americans were served by the nation's hospice providers last year, but patients, their families, and their physicians often don't know how to choose the best program for hospice, reports the National Hospice and Palliative Care Organization.
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Volunteers contribute valuable services to hospice patients, but hospices generally don't publicize the use of volunteers to the general community. A recent study shows that educating the public about the services provided by hospice volunteers increases the likelihood that they would select hospice service.
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Keep it simple. Start with one study. Pick an event or symptom that is easy to monitor. As hospice managers began looking for ways to meet the Quality Assessment Performance Improvement (QAPI) requirements of the new hospice Conditions of Participation, experts recommended that hospices new to performance improvement studies choose a study that is easy to monitor, analyze, and implement improvement strategies.
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Inclusion of all nursing staff members in the development of the falls risk assessment tool for Hernando Pasco Hospice in Hudson, FL, improved acceptance of the program and resulted in decreases in falls in the care centers using the tool, says Cyndi Cortes, RN, CHPN, administrator of the hospice's Marliere Care Center in New Port Richey, FL.
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Assessing a patient's risk level for falls is an important part of any falls reduction program but having a policy or guidelines that describe appropriate interventions also is essential.
