Improving Inpatient Hospice Care

Monday, 30 October 2017: 1:35 PM

Kristen Nall, MSN
Endoscopy, Midland Memorial Hospital, Midland, TX, USA

Problem: Hospice patients are admitted to the hospital and placed on the medical unit where nurses are not familiar with caring for hospice patients.

Goal: To improve the care of hospice patients on the inpatient medical unit by increasing nursing knowledge on key elements of inpatient hospice care

Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations (ANA, 2016). A Hospice Nurse cares for patients at the end of their lives. Their main responsibility is to help people live as comfortably and independently as possible and with the least amount of pain, in their final days. One of the largest parts of being a Hospice Nurse involves helping patients, and their families feel more comfortable about death and providing them with the emotional support they need (Johnson, 2014).

Common Hospice Medications

Morphine Sulfate

Morphine sulfate is used to reduce pain and can also minimize shortness of breath, treatment is started at the lowest dose and increased if symptoms become worse. The most common side effects are sedation, mild nausea and constipation. (Hospice, 2012)

Lorazepam (Ativan)

Lorazepam is used to reduce anxiety and/or restlessness it can also be used for shortness of breath and insomnia. The most common side effect of Lorazepam is sedation. (Hospice, 2012) It is acceptable to give both Lorazepam and Morphine at the same time if needed for comfort.

Atropine Drops (Sublingual Use)

Atropine drops are used to reduce lung congestion. The drops are administered in the mouth or under the tongue. The most common side effect of Atropine is dry mouth. Providing sips of water or ice chips or swabbing the patient’s mouth can reduce mouth dryness caused by Atropine. (Hospice, 2012)

This program is a creative helpful tool to be able to make a difference within our hospital community. Being able to have an outlet to come together to discuss ideas is great for morale, team building, education and personal growth. The Academy of Inquisitive thinking was a way for front line staff to look deeper into questions that we have and use research and evidence based practice to find answers and solutions. Research has always been an intimating task and with the help of the Academy of Inquisitive Thinking I was able to learn how to breakdown the daunting task of researching and implementing a project. My Project on inpatient hospice care within organization was very well received and because of this project I was able to educate hospital staff on the standards of practice for hospice patients.