Palliative Care Education and Serious Illness Communication Training for Baccalaureate Nursing Students.

Background: Palliative care is an essential component of community health for a growing population of seriously ill older adults residing in the community. Yet, nursing students are often challenged in initiating and engaging in serious illness conversations.

Purpose: This study implemented and evaluated an educational activity designed to increase nursing students' skills and self-efficacy to initiate and conduct conversations with patients/clients experiencing serious illness.

Addressing Cultural Competency and Primary Palliative Care Needs in Community Health Nursing Education.

To meet the primary palliative care needs of older adults, especially the underserved and those of color, a qualitative descriptive study was conducted among nursing students (n = 34) in community health nursing whose clinical rotations included independent living facilities for low-income populations. Two themes were identified that influence student nurse confidence and self-efficacy in initiating conversations with seriously ill clients and assessing their primary palliative care needs: (1) emotional assessment skills and cultural competency and (2) an assessment guide to primary palliative care needs that provides structure and guidance to conduct such conversations. Two major categories were identified that influence student nurse confidence and self-efficacy in initiating conversations with seriously ill clients: (1) educational needs and desired experience and (2) cultural impact.

The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study.

The objective of this study was to explore how home care workers and the agencies that employ them interact with their state's nurse practice act in the provision of care. Using a qualitative case study approach, we selected four states with varying levels of restrictiveness in their nurse delegation regulations. We conducted interviews ( = 45) with state leaders, agency leaders, and home care workers to learn how these policies affect the home care workforce's ability to perform care tasks for their clients in order to allow clients to remain in their own homes.

Consensus-Based Recommendations for an Adequate Workforce to Care for People with Serious Illness.

The lack of an adequately prepared workforce is a critical barrier to delivering high-quality community-based care for individuals living with serious illness. This article presents 16 consensus-based recommendations to improve the capacity of the workforce in this area within the next 5 years, focusing on older adults. The recommendations were developed at a summit of 40 national leaders from practice, payment, labor, advocacy, and research arenas.

Facilitators and Barriers to Interdisciplinary Communication between Providers in Primary Care and Palliative Care.

Background: Community-based palliative care (CBPC) plays an integral role in addressing the complex care needs of older adults with serious chronic illnesses, but is premised on effective communication and collaboration between primary care providers (PCPs) and the providers of specialty palliative care (SPC). Optimal strategies to achieve the goal of coordinated care are ill-defined.

Objective: The objective of this study was to understand the facilitators and barriers to optimal, coordinated interdisciplinary provision of CBPC.

Community-Based Palliative Care Leader Perspectives on Staffing, Recruitment, and Training.

To assess perspectives of US community-based palliative care program leaders on staffing, recruitment, and training, a qualitative descriptive study was conducted. Leaders (n = 20) from academic medical centers, large integrated and community health systems, home health and hospice organizations, and the Veterans Administration were recruited. Three major categories emerged that influence community-based palliative care workforce team composition across settings: (1) staffing models and recruitment are influenced by setting and workforce experience, (2) training varies by setting, and (3) demand exceeds supply of trained workforce.

Characteristics of Older Adults in Primary Care Who May Benefit From Primary Palliative Care in the U.S.

Context: Older adults with advanced illness and associated symptoms may benefit from primary palliative care, but limited data exist to identify older adults in U.S. primary care to benefit from this care.

Few Hospital Palliative Care Programs Meet National Staffing Recommendations.

The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard.