• J Palliat Med · Jun 2005

    Randomized Controlled Trial Clinical Trial

    A quality improvement intervention to increase palliative care in nursing homes.

    • Laura C Hanson, Kimberly S Reynolds, Martha Henderson, and C Glenn Pickard.
    • Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, 27599, USA. Laura_Hanson@med.unc.edu
    • J Palliat Med. 2005 Jun 1;8(3):576-84.

    ContextDeath is common in nursing homes, but access to palliative care is limited.ObjectiveTo test whether a quality improvement (QI) intervention in nursing homes increases hospice, pain management, and advance care planning.Design And SettingThe QI intervention was tested in seven nursing homes using a prepoststudy design. Two additional nursing homes served as control sites.ParticipantsNine nursing homes serving 1169 residents.InterventionThe intervention included recruitment and training of Palliative Care Leadership Teams in each facility, followed by six technical assistance meetings for team members. Hospice providers delivered six educational sessions for all nursing home staff using a structured curriculum. Teams received feedback of performance data on hospice enrollment, pain management, and advance care planning at 0, 3, and 6 months.Main Outcome MeasuresPercentage of residents receiving hospice or palliative services, pain assessment, pain treatment among residents in pain, and documented advance care planning discussions.ResultsIntervention facilities increased hospice enrollment from 4.0% of residents at baseline to 6.8% postintervention (p = .01) and increased pain assessments from 18% to 60% (p < .001). Among resident in pain, orders for nonpharmacologic pain treatments increased from 15% to 35% (p < .001), but pain medication use did not change. Residents with in-depth discussions about end-of-life care increased from 4% to 17% (p < .001). There were no significant changes in control sites.ConclusionsA quality improvement intervention was effective in increasing hospice enrollment, pain assessment, nonpharmacologic pain treatment, and advance care planning discussions.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.