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Implementing Strategies to Increase Referrals From Home Health to Hospice
Implementing Strategies to Increase Referrals From Home Health to Hospice
Implementing Strategies to Increase Referrals From Home Health to Hospice

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자료유형  
 학위논문 서양
최종처리일시  
20260202103059
ISBN  
9798315703525
DDC  
610.73
저자명  
Sutton, Meagan.
서명/저자  
Implementing Strategies to Increase Referrals From Home Health to Hospice
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2024
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2024
형태사항  
40 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
주기사항  
Advisor: Kitzmiller, Rebecca.
학위논문주기  
Thesis (D.N.P.)--The University of North Carolina at Chapel Hill, 2024.
초록/해제  
요약Although hospice care is associated with greater rates of moral support, consistent care, comfort, and peace during end of life in comparison to home health, only 12-15% of all Medicare eligible recipients receive hospice care. Without hospice services patients and families may experience undue burden related to unmanaged symptoms, fear, anxiety, isolation, and loneliness associated with terminal illness. Conversely, when in hospice, patients experience improved pain assessment and symptom management, better bereavement outcomes and overall satisfaction, and lower mortality rates among family members of patients who received hospice care. While recent studies about barriers to hospice are lacking, knowledge deficit, lack of training, provider attitudes and poor patient knowledge, may contribute to low rates of hospice referral. This quality improvement project aimed to improve identification of hospice-eligible patients and increase hospice referrals for Medi Home Health and Hospice patients using three strategies: education, electronic screening and regular communication. Education and support tools were created and then provided to all 29 home health staff and five leadership members during a face-to-face education session using a presentation and supported by handouts. Each week, the hospice director and home health director collaboratively reviewed patients identified through an electronic health record tool to determine readiness for hospice and potential transfer from home health. From among patients receiving home health care, 19 were identified as hospice eligible. Out of the 19 patients, 15 were admitted to hospice services and four declined hospice services. A key concern for Medi Home was the observation that many patients died within a short period of time following admission to hospice, thus they received little benefit from services. Patients who receive hospice care throughout a longer length of stay, experience more comprehensive benefits for themselves and their families to include symptom management, emotional, spiritual, and psychosocial support, better bereavement outcomes, and reduced family burden. As found in this project, there often are patients on or about to be discharged from home health services who meet all the eligibility criteria for hospice.
일반주제명  
Nursing
일반주제명  
Mental health
일반주제명  
Medical imaging
키워드  
Home health
키워드  
Hospice
키워드  
Terminal illness
키워드  
Psychosocial support
키워드  
Electronic screening
기타저자  
The University of North Carolina at Chapel Hill Nursing
기본자료저록  
Dissertations Abstracts International. 86-11B.
전자적 위치 및 접속  
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MARC

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■006m          o    d                
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■020    ▼a9798315703525
■035    ▼a(MiAaPQ)AAI31933790
■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a610.73
■1001  ▼aSutton,  Meagan.
■24510▼aImplementing  Strategies  to  Increase  Referrals  From  Home  Health  to  Hospice
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2024
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2024
■300    ▼a40  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-11,  Section:  B.
■500    ▼aAdvisor:  Kitzmiller,  Rebecca.
■5021  ▼aThesis  (D.N.P.)--The  University  of  North  Carolina  at  Chapel  Hill,  2024.
■520    ▼aAlthough  hospice  care  is  associated  with  greater  rates  of  moral  support,  consistent  care,  comfort,  and  peace  during  end  of  life  in  comparison  to  home  health,  only  12-15%  of  all  Medicare  eligible  recipients  receive  hospice  care.  Without  hospice  services  patients  and  families  may  experience  undue  burden  related  to  unmanaged  symptoms,  fear,  anxiety,  isolation,  and  loneliness  associated  with  terminal  illness.  Conversely,  when  in  hospice,  patients  experience  improved  pain  assessment  and  symptom  management,  better  bereavement  outcomes  and  overall  satisfaction,  and  lower  mortality  rates  among  family  members  of  patients  who  received  hospice  care.  While  recent  studies  about  barriers  to  hospice  are  lacking,  knowledge  deficit,  lack  of  training,  provider  attitudes  and  poor  patient  knowledge,  may  contribute  to  low  rates  of  hospice  referral.  This  quality  improvement  project  aimed  to  improve  identification  of  hospice-eligible  patients  and  increase  hospice  referrals  for  Medi  Home  Health  and  Hospice  patients  using  three  strategies:  education,  electronic  screening  and  regular  communication.  Education  and  support  tools  were  created  and  then  provided  to  all  29  home  health  staff  and  five  leadership  members  during  a  face-to-face  education  session  using  a  presentation  and  supported  by  handouts.  Each  week,  the  hospice  director  and  home  health  director  collaboratively  reviewed  patients  identified  through  an  electronic  health  record  tool  to  determine  readiness  for  hospice  and  potential  transfer  from  home  health.  From  among  patients  receiving  home  health  care,  19  were  identified  as  hospice  eligible.  Out  of  the  19  patients,  15  were  admitted  to  hospice  services  and  four  declined hospice  services.  A  key  concern  for  Medi  Home  was  the  observation  that  many  patients  died  within  a  short  period  of  time  following  admission  to  hospice,  thus  they  received  little  benefit  from  services.  Patients  who  receive  hospice  care  throughout  a  longer  length  of  stay,  experience  more  comprehensive  benefits  for  themselves  and  their  families  to  include  symptom  management,  emotional,  spiritual,  and  psychosocial  support,  better  bereavement  outcomes,  and  reduced  family  burden.  As  found  in  this  project,  there  often  are  patients  on  or  about  to  be  discharged  from  home  health  services  who  meet  all  the  eligibility  criteria  for  hospice.
■590    ▼aSchool  code:  0153.
■650  4▼aNursing
■650  4▼aMental  health
■650  4▼aMedical  imaging
■653    ▼aHome  health
■653    ▼aHospice
■653    ▼aTerminal  illness
■653    ▼aPsychosocial  support
■653    ▼aElectronic  screening
■690    ▼a0569
■690    ▼a0574
■690    ▼a0347
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bNursing.
■7730  ▼tDissertations  Abstracts  International▼g86-11B.
■790    ▼a0153
■791    ▼aD.N.P.
■792    ▼a2024
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17356909▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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