Evidence-Based Approaches in Hospice: Supporting Acute Care Graduates

This report addresses the challenges faced by a recent graduate with experience in acute care who transitions to a home healthcare nurse role caring for hospice patients. The report identifies the research problem, formulates searchable questions using the PICO model, and identifies relevant databases (NCBI, NIH) for literature review. It explains search strategies, identifies two pieces of evidence relevant to the scenario, and describes the first two steps (ask and acquire) of evidence-based practice. The report concludes by emphasizing the difficulties in understanding hospice care and the need for spending more time in understanding the preparation and performance within the support and care towards the individual.

Evidence based services

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Searchable questions..............................................................................................................1
PICO model............................................................................................................................1
Search strategies.....................................................................................................................1
Two evidence..........................................................................................................................1
The first 2 steps (ask and acquire) of Evidence-based Practice.............................................1
CONCLUSION................................................................................................................................1
REFERENCES................................................................................................................................2

INTRODUCTION
Acute care is defined as a branch of secondary health care where the number of patients
receives but it is also based on the short-term treatment which acts as an intervention that allows
the individual to deal with the short injury or the episode of the illness. In this, the urgent
medical condition or the during recovery of the patient who usually followed the aspect of
surgery. In terms of medical care, acute health disorder is being associated with the differing of
long-lasting care or longer-term care (Hotchkiss and et. al., 2018). Whereas, the term clinic care
is defined as the unusual caring of care that usually focuses on the quality of life for the persons
and their caregiver who is recent experience and advanced life-limiting illness such as the last
stage of cancer with a limited period. Moreover, it is also about care and support which is based
on the end of life. in this report, the graduate practitioner forms the acute care was assigned in
the hospice care that creates a challenging scenario for the graduate (Lindley and et. al., 2019).
MAIN BODY
Searchable questions
 What is the concept of acute care?
 What is the concept of hospice care?
 What is the major difference between acute care and hospice care?
 What is the challenge faced during hospice care?
 What is the impact occurring on the patient when acute care practitioners are treated as
hospice care?
 What are the major strategies used to provide quality of health in hospice care as acute
care graduate?
 What is the situation that arises issue with acute care graduates in dealing with patients in
hospice care?
PICO model
Population/problem  Several populations facing issues with
end-of-life.
 Several populations need hospice care
for the slow progress of the disease.
 A problem faced by people in hospice
1

care
 The critical end-of-life situation is
faced by several patients that require
hospice care.
Intervention  Provide proper support and care.
 Maintain and regulate ethical pain
management with the patient who is
dealing with the critical issue and
requires hospice care.
 Provide timely medication and self-
management activities that promote a
healthy lifestyle.
 Develop a routine for exercise and yoga
that enhances the immune system
which slows the rate of progression of
disease with the patient with the end of
life.
Comparison  The self-management is required with
proper education to the patient to deal
with some normal situations.
 Develop learning to understand the
psychological aspect to deal with and
complete the need of the patient.
 Provide a relevant approach that is
fulfilled towards the patient to generate
wellbeing and resilience.
 Promote healthy behavior and restrict
unhealthy approaches.
Outcome  Promote wellbeing and resilience.
 Develop healthy behavior.
2

 Maintain behavior that is productive for
the patient in order to develop the
quality of care and support.
Two databases for literature review
NCBI Palliative and supportive care are usually making difference in the philosophy of
strategies based on precaution. Usually, the focus on the primary approach to
hospice care shows the relevance regards with the disease rather than its cause for
specific issues. While taking the aspect of hospice care, it requires full dedication
and a multidisciplinary approach in order to provide support and care to several
individuals. The works are also explained about the state which is based on the
oncological or antiviral agent action that needs prolonged support and cares for the
enduring which is regulated only by hospital care. While taking the previous
perspective of palliative care and hospice services then they take various time and
energy to perform but in the aspect of reality, they are initiated or started at the
time of analysis. The cost efficiency towards the relaxing care efforts the disease
in terms of quality of life for the family and individual (Lindley and et. al., 2021).
NIH Some people are dying in amenities such as a hospital or treatment home receiving
upkeep that is not permanent as per their wants. Moreover, the older people need
to plan hospice care who used to show their preferences in the end-of-life patients.
While taking the contrast of an example, the older person wants to die at home
then they have the authority to receive the end-of-life care for their pain and other
symptoms which makes this known to health care workers and domestic. It is
usually measured as a comparison to dying in a hospital while receiving unwanted
treatment. However, palliative care is usually particular medicinal care for people
alive with a serious disease such as growth or any kind of cardiovascular disease.
Moreover, patients in palliative care may obtain medicinal care for their indicators
or palliative care or hospice care. Palliative care and hospice care are usually
meant to increase the person's current care by concentrating on the quality of life
for them and their family (Park and et. al., 2017).
3

Search strategies
Database Search strategies
NCBI The search policy which shows the indication on the hospice care is typically
recommended by a methodical review that was custom-built by the Wales Office for
investigation and expansion which is helpful to evaluate the effectiveness and cost-
effectiveness of the hospice care team. Moreover, the review is helpful to show the
evidence of advantages and terms of patient and caregiver outcome as a result. The
work suggests that home care is not less expensive than inpatient hospice care. The
research shows a various aspect in their search strategy because it's followed various
condition and situation that is based on experiment, survey, and case studies. While
researching this area they used to suggest some points that are needed for more
evaluation of services measurement of outcome and assessment of economic effect.
However, the report is usually suggested that palliative care and specialized palliative
care services play a significant role by the national health services as an effective
method of providing support and care for the patient in their critical illness. It also
calls for the evaluation of different models of the hospice care team and they are
relatable with the hospital home and inpatient hospice support and care. The search
strategy also focuses on the various analysis of the type of delivered care and support
by the hospice care team. In this, other teams also suggest a better outcome with full
specialized and intermediate level teams than with generic care. While taking the
contrast of hospice care, they play a vital role in order to provide quality support and
care to the individual and their family. The search strategy focused on the various
aspect that promotes wellbeing and resilience in terms of hospice care (Soroka and et.
al).
Two pieces of evidence
As per the determination of two shreds of evidence from the search which is relevant to the
scenario is that the palliative care or hospice care is usually helpful to provide support with the
patient on the level of emotional and cognitive. In this scenario, when a graduate from the acute
care setting is assigned to hospice care usually creates difficulties in understanding the scenario
of the hospice care team. The graduate notice that some of the family members or caregivers of
4

the patient in hospice care are withdrawn. Then they wonder that the family caregiver is gone
through the various critical phase and they require quality care. As per the search strategy, it's
also accessible to the quality of care and health. The second piece of evidence state that a large
number of populations are usually facing issues with the need for hospice care. So, graduates
assigned to hospice care do have not enough experience regards with the end of life who have
received hospice care. Instantly, they decided themselves provide quality of care that is evaluated
under the evidence (Yang and et. al., 2017).
The first 2 steps (ask and acquire) of Evidence-based Practice
The two-step, ask and acquire of evidence-based practices is applicable in the situation because
the graduate from the acute care setting is transferred to hospice care which comes at the
condition of asking to provide support and care. They acquire the position by providing quality
care with the number of patients that show evidence-practice within the health care setting.
CONCLUSION
As per the above discussion, it is well analyzed that the graduate with the two-year
experience in the acute care setting is usually assigned for hospice care. It is a very difficult task
and challenging approach for the graduate within the hospice care since the graduate has their
concentration and knowledge in the acute care settings. It is very problematic to recognize the
nature and environment of hospice care. As per this, to create a better understanding in the
hospice care they used to spend more time in understanding the preparation and performance is
of a team within the support and care towards the individual. Moreover, they must focus on the
roles and responsibilities of the hospice care team and their approach which they regulated for
the compliance of patient safety and support. Overall, it is difficult for the graduate to create
understanding instantly and perform the role and responsibilities of the hospice care with the
number of patients.
5

REFERENCES
Books and Journals
Hotchkiss and et. al., 2018. Mindful self-care and secondary traumatic stress mediate a
relationship between compassion satisfaction and burnout risk among hospice care
professionals. American Journal of Hospice and Palliative Medicine®, 35(8), pp.1099-
1108.
Lindley and et. al., 2019. Children enrolled in hospice care under commercial insurance: A
comparison of different age groups. American Journal of Hospice and Palliative
Medicine®, 36(2), pp.123-129.
Lindley and et. al., 2021. Patterns of Health Care Services During Pediatric Concurrent Hospice
Care: A National Study. American Journal of Hospice and Palliative Medicine®,
p.10499091211018661.
Park and et. al., 2017. A comparison of hospice care research topics between Korea and other
countries using text network analysis. Journal of Korean Academy of Nursing, 47(5),
pp.600-612.
Soroka and et. al., 2018. Family caregivers’ confidence caring for relatives in hospice care at
home: An exploratory qualitative study. American Journal of Hospice and Palliative
Medicine®, 35(12), pp.1540-1546.
Yang and et. al., 2017. Factors associated with the attitudes of oncology nurses toward hospice
care in China. Patient preference and adherence, 11, p.853.
6