Evidence Review Paper

Evidence Review
The topic of the underutilization of PC has generated a vast amount of research and scholarly debate during the last twenty years. The foundation of this proposal was to first examine the evidence that contributes to this complex problem. The primary issues exposed during the research review were related to length of stay (LOS), the patients pain and suffering, timing of a PCC, prolonging death rather than prolonging quality of life, and lack of education on the part of the provider. The databases used for this research included Pub Med, CINAHL, ProQuest, and AHRQ. This extensive research included the following five studies.
Relevant Research Studies
Fedel, Joosse and Lee (2013) designed a cohort study that was
The sample consisted of 239 patients who were under the care of the PC team. The patient‘s and families that completed the DA intervention reported it was very useful. The problem was the majority felt it would have been more useful earlier in the course of their situation. This confirms that education of patients and family’s needs to begin in the office, not the hospital, regardless of if they have a PPC.
May, Normand and Morrison ( 2014) considered the effect of PCC on the hospital costs in a large systematic review of ten studies that assessed cost and PC teams. This systematic meta review revealed that when inpatients are under the care of PC, hospital costs are reduced by 9-25%. When PCC originate in a timely manner cost for levels of care (ICU vs floor) , procedures, and diagnostics are reduced. This study also implies that as a larger issue we need to include the last six months of a person’s life health care costs with PC and
The theory is based on the personal, interpersonal and social factors that influence health, disease and outcomes (www.nursingtheory.org). When applied to this proposal, the nurse assesses the patient both physically, mentally and socially. Part of this admission assessment would be the PC screening tool. This would be instrumental in alerting the PC team to a situation in which the patient either has a terminal illness, is suffering, or is unlikely to survive their hospital admission. In these situations the families are typically upset, and often lack the emotional support to make difficult decisions. Nursing theory laid the foundation for what nurses at every level preform. As nurses both RN’s & ARNP’s the foundation of our practice is Nursing Theory. It’s the “why” of what we automatically do. King’s work initiated the concept of treating patients in the context of their reality, as part of a lager