Briefings: Consensus paper on legal issues in the care of patients with pressure ulcers [Новость добавлена - 02.12.2009]

December 2, 2009 Consensus paper on legal issues in the care of patients with pressure ulcers In an article from the International Expert Wound Care Advisory Panel published in the Journal of Palliative Medicine, the authors outline some of the legal issues associated with pressure ulcers. Lawsuits over decubitus ulcers are common in acute and long-term care settings, with judgments as high as $312 million in a single case. In a sidebar, one of the authors, Diane L. Krasner, PhD, RN, suggests 10 tips for keeping legally safe when providing wound and skin care. These include specifically describe the wound, document the skin condition on admission and discharge, obtain referrals to a specialist when indicated, provide consistent treatments, document interventions, modify the plan of care as changes dictate, notify leaders about possible red flag conditions, and maintain your own liability insurance policy. http://www.liebertonline.com/doi/pdfplus/10.1089/jpm.2009.9939

CAPC offers education techniques course The Center to Advance Palliative Care has announced the availability of a new online course titled Education Techniques in Palliative Care. The course will review common instructional goals of palliative care programs, educational learning objectives, and common teaching methods. Participants will use worksheets and a sample lesson plan to design an education program that can be used by health professionals within their clinical setting. The activity has been approved for 2 AMA PRA Category 1 Credits™ and CE credits for nurses and social workers will be provided. http://campus.capc.org/PalliativeCareCourses/EducationTechniquesinPalliativeCare

End-of-life care decision making associated with timely diagnosis of dying Identifying advanced cancer patients who were dying was associated with early establishment of code status, supportive care plans, and discontinuation of cancer therapy. U.S. and Canadian researchers retrospectively collected data, including cancer treatments and care goals, for 118 consecutive patients who died at the Vancouver Cancer Center between January 2005 and December 2006. Median length of stay was 10 days, with patients receiving a median of two tests per day, with a decreasing trend over time. Forty percent of patients received cancer treatments during their stay, with 75% stopped early. Starting supportive care and identifying that the patient was dying was linked with timely abandonment of the cancer treatments. The authors concluded that early establishment of goals of care may be associated with changes in practice consistent with improved quality of care. http://www.sciencedirect.com/science...

Harvard Center for Palliative Care accepting applications The Harvard Medical School Center for Palliative Care began accepting applications for its Program in Palliative Care Education and Practice program, December 1, 2009. The two-part program for physician and nurse educators will take place April 27-May 4, 2010, and November 9-15, 2010, following a six-month interim, during which participants work on an individual project. The program focuses on teaching the fundamentals of palliative care, communication at end-of-life, managing challenges in palliative care education, and developing and promoting such programs. There will also be a focus on the unique aspects of pediatric palliative care in a pediatric track. http://www.hms.harvard.edu/pallcare/pcep.htm

Intravenous to oral morphine dosing for cancer pain Researchers at the Cleveland Clinic in Ohio conducted a prospective, observational study to confirm the efficacy and safety of converting 106 inpatient cancer patients from intravenous to oral morphine at a ratio of one to three. Sixty-two patients were successfully switched and included in the analysis. The researchers considered the switch successful if the patient's pain was adequately controlled, they needed fewer than four rescue doses per 24 hours, and they experienced no limiting side effects. The team was able to successfully convert about 80% of the patients to oral morphine, following the 1:3 ratio, with the balance requiring an oral dose adjustment, up or down, to improve pain relief or limit side effects. The authors concluded that the 1:3, IV to oral relative milligram potency ratio appears correct and practical for most patients. http://pmj.sagepub.com/cgi/content/abstract/0269216309346595v1?papetoc

MedPAC discusses hospice visit patterns At its November 5 public meeting the Medicare Payment Advisory Commission discussed an analysis of hospice visit patterns, as they evaluated making recommendations for changes to payment for hospice services by the Medicare payment system. Proposals include changing from a flat per diem payment to one in which rates vary during the course of care. MedPAC solicited comments on the agenda through its Web site. http://www.medpac.gov/meeting...   http://www.medpac.gov/transcripts/...

New Grand Rapids fellowship program Hospice of Michigan, Grand Rapids Medical Education and Research Center and several community hospitals and organizations have developed a one-year fellowship program in partnership with the Michigan State University College of Human Medicine to offer a fellowship in hospice and palliative care. The hospice has raised more than $1 million toward establishing an endowment to support the fellowship. Training will take place in inpatient and home settings and longitudinal rotations at a community hospice program and an outpatient palliative continuity clinic. The fellowship offers opportunities for elective rotations in Interventional Pain, Integrative Medicine, Intensive Care, and other specialties. http://www.grmerc.net/hospice_palliative/index.html

Holiday ornament raises money for hospice The Center Court Hospice in Binghamton, N.Y., is selling slip-cast porcelain, handcrafted, collectable ornaments, the proceeds of which will support the hospice. The mother-of-pearl decorated ornaments are kiln fired and hand polished, with an attached ribbon and bow to easily hang it. The company is owned by Bill Dransfeldt and his wife, Leeanna, who is a nurse, and they produce ornaments for several hospitals and hospices. http://www.lourdes.com/News_and_Events/view_news.aspx?id=194

National Institute of Nursing Research releases new palliative care brochure A new brochure, "Palliative Care: The Relief You Need When You're Experiencing the Symptoms of Serious Illness," produced by the National Institute of Nursing Research, highlights the benefits of palliative care and the comprehensive treatments available to reduce or eliminate pain and other symptoms. The free brochure includes information about deciding when someone needs palliative care, how to ask a provider to prescribe it, specialists on the palliative care team, and insurance coverage for the care. It also explains the difference between palliative care and hospice. "Our goal is to increase the number of provider-patient conversations about palliative care resources, so that fewer patients suffer needlessly from pain and distressing symptoms," said Patricia A. Grady, NINR director. http://www.ninr.nih.gov/NR/rdonlyres/...

60 Minutes features story about cost of end-of-life care The CBS news program 60 Minutes profiled the cost and challenges of end-of-life care. The program highlighted how Medicare paid $50 billion for the care of patients in the last two months of life last year. It focused on how patients deny death and spend their last days in ICU, receiving uncomfortable procedures that often cannot change the inevitable outcome. During this section of the November 22, 2009, program, viewers witnessed patients asking that everything can be done, even when it does not appear to make any sense. http://www.cbsnews.com/video/watch...

People on the Move The following individuals were awarded the Justin T. Rogers Spirit of Hospice Award by Hospice of Visiting Nurse Service, Akron, Ohio, for embodying the compassion, spirit and quality of hospice; Russell M. Pry, Executive, Summit County, David J. Peter, MD, FACEP, Hospice of VNS Medical Director and Akron General Chief Medical Information Officer, and Molly Kramer Scantling, MD, Hospice of VNS Medical Director...Jean Bartels, PhD, RN, Georgia Southern University Chair and Professor of Nursing and President of the Board for the Ogeechee Area Hospice, Inc., Statesboro, Georgia, was selected as the 2009 recipient of the Sister Bernadette Armiger Award, the highest honor given by the American Association of Colleges of Nursing...Mark Hazelwood has been appointed the new Director of The Scottish Partnership for Palliative Care...Amy M. Kramer, RN, CN II, of Duke University Hospital received the Drew Award for Excellence in Hospice Nursing Practice...Dr. Lisa Rome recently joined Hospice of the North Shore in Danvers, Massachusetts, as a palliative care physician...Please send your People on the Move news to: Briefings@liebertpub.com

Mary Ann Liebert, Inc.