The Effect of the Timing of a Hospice Referral and the Perceived Quality of Care by the Family

Start Date

April 2020

End Date

April 2020

Major Field of Study

Nursing

Student Type

Undergraduate - Honors

Faculty Mentor(s)

Patricia Harris, PhD, RN, CNS

Presentation Format

Oral Presentation

Abstract/Description

Hospice care was created in 1974 to provide end of life care for a seriously ill person during the final stages of his or her life. It is available to any person with a six-month or less life expectancy. Rather than chasing a cure, hospice focuses on the quality of the person’s life. Hospice services include pain and symptom management, respite care for family members, and other palliative care services. The purpose of hospice is to aid in alleviation of suffering and acceptance of death as the final stage of life, so that that terminally ill people may spend their last days with dignity and comfort, surrounded by loved ones.

Despite its benefits, hospice remains underutilized. The National Hospice and Palliative Care Organization (NHPCO) recommend that clients receive a minimum of 90 days in hospice to provide optimal multidimensional end-of-life care (2019). In contrast to the ideal 90-day hospice stay, the median hospice stay is approximately 24 days. Short durations do not give the interdisciplinary team time to provide the maximum benefits of hospice and often result in unmet needs and dissatisfaction. A key reason behind the underuse of hospice is the late timing of referrals, often made within the last weeks or days of life (NHPCO, 2019).

Therefore, further research is needed on the barriers that influence the timing of a hospice referral, as well as barriers influencing the integration of a hospice program once a referral is made. The purpose of this research is to describe barriers to utilization of hospice services as perceived by the nurses who care for patients with serious illnesses who may benefit from a referral. Since oncology nurses are known to care for patients with terminal diagnoses, this study will focus on that population. The research questions proposed are (1) How do experienced oncology nurses describe barriers to the timing of a hospice referral; (2) Once a hospice referral is made, how do experienced oncology nurses describe the barriers the family face in implementing hospice care?

Comments

This presentation was accepted for the Scholarly and Creative Works Conference at Dominican University of California. The Conference was canceled due to the Covid-19 Pandemic

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The Effect of the Timing of a Hospice Referral and the Perceived Quality of Care by the Family

Hospice care was created in 1974 to provide end of life care for a seriously ill person during the final stages of his or her life. It is available to any person with a six-month or less life expectancy. Rather than chasing a cure, hospice focuses on the quality of the person’s life. Hospice services include pain and symptom management, respite care for family members, and other palliative care services. The purpose of hospice is to aid in alleviation of suffering and acceptance of death as the final stage of life, so that that terminally ill people may spend their last days with dignity and comfort, surrounded by loved ones.

Despite its benefits, hospice remains underutilized. The National Hospice and Palliative Care Organization (NHPCO) recommend that clients receive a minimum of 90 days in hospice to provide optimal multidimensional end-of-life care (2019). In contrast to the ideal 90-day hospice stay, the median hospice stay is approximately 24 days. Short durations do not give the interdisciplinary team time to provide the maximum benefits of hospice and often result in unmet needs and dissatisfaction. A key reason behind the underuse of hospice is the late timing of referrals, often made within the last weeks or days of life (NHPCO, 2019).

Therefore, further research is needed on the barriers that influence the timing of a hospice referral, as well as barriers influencing the integration of a hospice program once a referral is made. The purpose of this research is to describe barriers to utilization of hospice services as perceived by the nurses who care for patients with serious illnesses who may benefit from a referral. Since oncology nurses are known to care for patients with terminal diagnoses, this study will focus on that population. The research questions proposed are (1) How do experienced oncology nurses describe barriers to the timing of a hospice referral; (2) Once a hospice referral is made, how do experienced oncology nurses describe the barriers the family face in implementing hospice care?