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Quality of Life & Patient Care

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Culture Change
| End of Life/ Palliative Care/ Advance Directives/ Death and Dying
Individualized Care | Pain Management | Quality of Life | Resident Assessment/MDS

Culture Change

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End of Life/ Palliative Care/ Advance Directives/ Death and Dying

  • “How Can Clinicians With Diverse Backgrounds and Trainings Collaborate With One Another To Care For Patients at the End of Life? Nursing Home/Hospice Partnerships”, (Brown Medical School, Robert Woods Johnson Foundation, January 2006) Discusses benefits to nursing home, hospice partnerships and steps for these relationships can be strengthened in promote resident care.
  • Fast Fact Worksheets:
    • Diagnosis and Management of Terminal Delirium, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #1, 2nd Edition, July 2005.) Reviews assessment and management issues in terminal delirium in the last two weeks of life.
    • Converting To-From Transdermal Fentanyl, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #2, 2nd Edition, July 2005.) Reviews conversions to and from Fentanyl transdermal.
    • Syndrome of Imminent Death, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #3, 2nd Edition, July 2005.) Reviews prompt recognition of active dying and appropriate interventions.
    • Treatment of Nausea and Vomiting, (Hallenbeck, Weissman, Medical College of Wisconsin, Fast Fact and Concept #5, 2nd Edition, July 2005.) Reviews commonly prescribed anti-emetics and their mechanisms of actions.
    • Depression in Advanced Cancer, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #7, 2nd Edition, July 2005.) Reviews diagnosing and providing treatment for a major depressive episode in patients with a terminal illness.
    • Tube Feed or Not Tube Feed, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #10, 2nd Edition, July 2005.) Reviews use of tube feedings and prevention of aspiration pneumonia.
    • Myths about Advance Directives, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #12, 2nd Edition, July 2005.) Discusses common barriers to properly completed advance directives.
    • Constipation, (Hallenbeck, Medical College of Wisconsin, Fast Fact and Concept #15, 2nd Edition, August 2005.) Discusses the four major components of normal bowel movements (solid waste, water, motility, lubrication) as related to end of life residents.
    • Moderating a Family Conference, (Ambuel, Weissman, Medical College of Wisconsin, Fast Fact and Concept #16, 2nd Edition, August 2005.) Reviews steps in conducting a family conference with terminal patients and their families.
    • Dyspnea at the End of Life, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #27, 2nd Edition, July 2005.) Reviews key elements in the assessment and treatment of dyspnea near the end of life.
    • Ventilator Withdrawal Protocol, (von Guten, Weissman, Medical College of Wisconsin, Fast Fact and Concept #33, 2nd Edition, July 2005.) Discusses steps for ventilator withdrawal on a ventilator dependent resident to allow for death once the decision has been made.
    • Ventilator Withdrawal Symptom Control, (von Guten, Weissman, Medical College of Wisconsin, Fast Fact and Concept #34, 2nd Edition, July 2005.) Discusses symptom control for anxiety, breathlessness, and sedation.
    • Ventilator Withdrawal Information for Patients and Families, (von Guten, Weissman, Medical College of Wisconsin, Fast Fact and Concept #35, 2nd Edition, July 2005.) Discusses physician involvement with counseling of patients and families for ventilator withdrawal.
    • Calculating Opioid Dose Conversions, (Arnold, Weissman, Medical College of Wisconsin, Fast Fact and Concept #36, 2nd Edition, July 2005.) Conversion tables for opioid dose conversions.
    • Discussing Hospice Care, (von Guten, Weissman, Medical College of Wisconsin, Fast Fact and Concept #38, 2nd Edition, July 2005.) Reviews hospice discussions with seriously ill patients using a step-wise approach.
    • Is it Grief or Depression, (Periyakoil, Medical College of Wisconsin, Fast Fact and Concept #43, 2nd Edition, August 2005.) Discusses distinguishing between a dying patient’s normal grief and a major depression.
    • Medical Management of Bowel Obstruction, (von Guten, Muir, Medical College of Wisconsin, Fast Fact and Concept #45, 2nd Edition, August 2005.) Malignant bowel obstruction is a common oncologic complication; most common in ovarian and colon cancer. This discusses treatment options most commonly used.
    • Medical Management of Bowel Obstruction, (Arnold, Medical College of Wisconsin, Fast Fact and Concept #55, 2nd Edition, July 2006.) Discusses informed consent- the principle that patients should be allowed to make decisions for themselves.
    • Dealing With The Angry Dying Patient, (Wang-Cheng, Medical College of Wisconsin, Fast Fact and Concept #59, 2nd Edition, September 2006.) A guide to managing situations with commonly expressed emotions by seriously ill residents.
    • Establishing End of Life Goals- The Living Well Discussion, (Ambuel, Medical College of Wisconsin, Fast Fact and Concept #65, 2nd Edition, July 2006.) Discussions for how to assist the patient where treatment becomes tools for achieving patient goals.

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Pain Management

  • Pain Management in the LTC Setting, (American Medical Directors Association- AMDA)
    CPG Pain Management in the LTC Setting is the AMDA Clinical Practice Guideline for pain control. Recognizes myths and overcomes barriers to pain control. ($)- Discount when purchased through AHCA Bookstore.
  • The Use of ‘As Needed’ Range Orders for Opioid Analgesics in the Management of Acute Pain, (Gordon, American Society for Pain Management Nursing, American Pain Society, 2004.) Consesus statement from the American Society for Pain Management Nurses (ASPMN) on steps nurses can take to for reliable pain assessment and effective pain treatment.

  • Fast Fact Worksheets:
    • Pseudoaddiction, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #69, 2nd Edition, July 2006.) Describes iatrogenic syndrome from poorly treated pain. Discusses diagnostic features and management.
    • PRN Range Analgesics, (Gordon, Medical College of Wisconsin, Fast Fact and Concept #70, 2nd Edition, July 2006.) Discusses considerations for writing and interpreting PRN Analgesic orders.
    • Oral Opiod Orders- Good and Bad Examples, (Weissman, Medical College of Wisconsin, Fast Fact and Concept #74, 2nd Edition, July 2006.) Illustrations of poorly written opioid orders, explanations, and preferred alternatives.
    • Cultural Aspects of Pain Management, (Gordon, Bidar-Sielaff, Medical College of Wisconsin, Fast Fact and Concept #78, 2nd Edition, July 2006.) Discusses the meaning and expression of pain as influenced by the person’s cultural background.

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Quality of Life

  • Quality of Life Assessment, (Borun Center for Gerontological Research, UCLA School of Medicine/ Jewish Home of Greater LA) The Borun Center for Gerontological Research (UCLA School of Medicine/ Jewish Home of Greater LA) resource quality of life (including instructions on engaging residents in customer satisfaction) includes training module.

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Resident Assessment/MDS

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Safely Reduce the Off-Label Use of Antipsychotics

Clinical Considerations of Antipsychotic Management Toolkit (Members Only Content - login required)

This resource uses a process framework to identify care objectives and expectations and offers tools and resources to help providers successfully manage antipsychotic medication use at the resident and facility level. The guide focuses on 7 critical steps needed to ensure quality outcomes that are successful and continuous.

 

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