End-of-Life and Prognostication

1. Read the Hospice fact sheet. Read through the facts and identify which parameter needs the most work. Granted we have come quite a long way from almost no one receiving the services of hospice but there is always a better performance.
2. Once you have selected the parameter, consider the best way to address this deficit.
3. You must design at least two different interventions to address the deficiency that will help change things so that future generations will enjoy the benefits of hospice.
4. When suggesting interventions, be sure to make them specific ideas.
5. Also, utilize the given numbers when quoting specific areas that need improvement.
6. Your paper should be:
– One (1) page or more.
– Use factual information from the textbook and/or appropriate articles and websites.
– Cite your sources and type references according to the APA Style Guide.

HOSPICE
In 2010, 41.9% had care (1 million/2.5 million)
In addition,
 35.3% died or were discharged within 7 days
 27% were 8-29 days
 17.2% were 30- 89 days
 8.7% were 90-179 days
 11.8% were other
Median LOS= 19.7 days
Top 5 diagnoses for death:
1. Cancer: 35.6%
2. Heart: 14.3%
3. Dementia: 13%
4. Unspecified: 13%
5. Lung Disease: 8.3%
66.7% =hospice patients died at home.
21.9%= hospice died in an inpatient facility
11.4% = died in an inpatient acute care hospital
Distribution:
Caucasian = 77.3%
African-American = 8.9%
Multiracial= 11%
Common scales for prognostication:
I. Karnofsky Performance Scale: (KPS) If <40 median survival is less than 3 months
II. Palliative Performance (PPS) If PPS ≤ 60 Median survival can be measured in weeks
III. Eastern Cooperative Oncology Group (ECOG) or WHO/Zubrod If >3 median survival
IV. Palliative Prognostic Score (PaP)= measured in weeks

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