End of Life Care

End of Life Care

 

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Abstract

End of life care is important for the life limiting diseases, care providers as well as their families. Healthcare providers have realized the need for end of life care for patients with life limiting diseases. The end of life care is aimed at improving the life of the patients during their final moment through interventions and approaches aimed at improving the patient outcomes. This research aims at examining the various facilities and techniques that are used by nurses in the emergency unit to save lives during the final periods. The research will show how the nurses in the emergency department have improved end of life care for the patients during their final moments. The study will reveal the end of life practices and the wide spread successes and accomplishments of end of life care. Developing such evidence through empirical and literature studies will reveal the influence of end of life care and the transformations in performs.

Introduction

The past few years have experienced vivid improvements in end of life care study. Not only have these developments led to an accepting of the burden of life limiting illnesses on families, patients, health professionals and the healthcare organization but have also recognized that the end of life care interventions can enhance the family as well as patient outcomes as well as lower the cost of care (Rubin, 2015). Individuals have increasingly aimed at living longer with numerus illnesses through advanced technology, advanced interventions as well as pharmaceuticals. People have preferred that patients continue to experience much dignity and comfort even at their final moments of living. Considerably, the end of life care is important because it lowers the prolonged death process, controls pain as well as offers a sense of control to their patients. The objective of this study will be to evaluate various methods that can be applied in the providing of care.

Background

Health care providers have recognized the essence of end of life care being an option for treatment for seriously ailing patients. The end of life care is an approach for enhancing life value for families and patients facing problems that have been linked to life threatening illness (Rubin, 2015). End of life care begins at a serious illness where it is given besides the treatment that is being utilized to combat a disease. It is a type of care that is offered during the final months of life and is relied on when the condition of the patient continues to deteriorate and the active treatment has failed to control the disease. End of life care takes care of persons with progressive, incurable and serious illnesses to live comfortably until they die (Stilos et al., 2016). Therefore, end of life care has been essential in improving the value of life to individuals that have a life time illness through offering care and advise.

Qualitative research question: What methods can the staff at the emergency department provide support to the end of life patients in a way that will facilitate better health and preserve dignity?

Literature Review

The paper comprehensively analyzes the literature review on the end of life as a major topic of concern. The end of life has been extensively researched and analyzed to assert the importance, patients’ experience, and capacity to improve the quality of health care, as well as, life satisfaction. The end of life marking the final days and/or moments of an individual are critical to giving a dignified ending. The pursuit of improved medical practices has been fundamental to ease the pain and experiences of patients in their final days (Rubin, 2015). This culminates in the emphasize to study more and improve to the body of knowledge asserting the significance of better care at the end of life.

Rubin (2015) explains that the final times in involvements of loved one dying brings about an aching situation for both the affected as well as the living person. The aggressive interventions have often been included to prove difficult moments during the last days. An evaluation of a study conducted in Spain illustrates how care is given to a dying patient. Inconsistency between the desires by the nurses in facilitating a good death and the authentic capability that will enable preservation of a patient’s dignity. Stilos et al., (2016) argues the significance of enhanced care to ensure pride of person having better final days. This is as a result of problem in communication in addition to organization and structural issues. The preservation of a dying patient’s dignity is risked due to overburdening caregivers and other environmental factors. Ho, (2016) indicates the occurrences, beliefs in addition to the attitude of the nurses towards the care provided in the emergency unit. The quantitative study affirms staff prioritize more on patients that have higher chances of living as compared to helping one to die. The standard practice as illustrated in the findings was to relocate a patient considered to require end of life care from the emergency unit earlier before death. Rubin (2015) relatively adds that notwithstanding the intensive care the healthcare professionals have improved the healthcare services. This has prompted the significance of health care services as well as the kind moments that a person has during their last days. Considerably the degree to which an individual is held off guard by the decease of their loved one is a profound issue. Ideally, it is hard to predict the end of life and the last moment that one is to experience their final breath.

Stilos et al., (2016) noted that state statistics have indicated that Canadians desire dying at home despite the fact that 50 percent of them die in hospital settings. Stilos et al., 2016 adds that the stress on having a person undergoing acute care unit may demonstrate highly upsetting environment for demise both for the families as well as patient. On the other hand, relatives as well as medical practitioners are often held in their attempt to offer cure to the sickness ailing the person rather than offering the appropriate care for their esteemed ones.

The study indicates that this involvement is painful contrary to offering better care thinkable. Thus, health professionals have lacked effective teaching in treating impending dying as well as capacity of controlling the death course. Ho (2016) argues that the involvement requiring enhanced professionalism, speedy processes and fast movement to make each attempt probable to end of life care is a challenge for the care providers at the emergency units.

The care givers in the emergency units have challenging times in evaluating the paramount care to offer to prevent painful and emotional experiences of an individual. Decker et al., (2014) argues that controlling demise in the intensive care unit is challenging. This is because of the nature of tasks given to the health providers to offer care to various ailing individual sets in a demanding and speedy moving redeemable setting that brings about the challenging moments. The dignity of an individual and attempts to ease the pain should be a primary objective at the end of life care compared to rigorous diagnosis and treatments to be administered on an individual (Stilos et al. 2016). The literature presents the value given to the nature of care provided to an individual in making the end of life more comfortable than painful treatments with potential to cause more suffering. The quality of health care can be measured with the context of dignity, ease of pain, and peacefulness administered to an individual in their final moments.

The research on the end of life has most often been an infringement of an individual’s privacy and rights to protect health care information. Cohen and Mello (2018) emphasize on value of health information protection and security from breach. Cohen and Mello (2018) notes that part of what enables individuals to live full lives in the knowledge that certain personal information is not on view unless that person decides to share it. The context is fundamental more so to patients experiencing end of life scenarios. This is critical for the protection of their privacy in the most difficult moments where all seems to be gone. It gives pleasure and peace of mind to know that such information is protected by law and individuals are at liberty of determining how such information can be used in the wake of difficult experiences (Edemekong & Haydel 2019).

The research on health care information accentuates the value of ethical considerations in sensitive information handling. The end of life health records used to inform the literature review on the subject is a sensitive matter that must be handled with subsequent care and caution. Edemekong and Haydel (2019) highlight that health care facilities have a mandate in the protection and security of confidential and private information. The sharing of the information is crucial in ascertaining the best care possible at the end of life scenario. The patient’s assurance of their health information’s protection facilitates the assertion of dignity and respect accorded to them. The disclosure of the information is part of the experiences in which an individual is accorded in their final moments (Cohen & Mello 2018). This culminates in the value of information protection as a component of health care provision. The pain of knowing your information has been disclosed without your knowledge or approval can be a painful context for the patient. Thus, optimum end of life care must be supplemented with vigilant health care information protection.

Ethical Considerations

The paper comprehensively analyzes the ethical considerations fundamental for the research topic investigations. In academia, the use of ethical considerations in the research investigations if crucial to assert the professionalism and backing of the study. The content utilized in the research informs the primary understanding of using existing literature and peer reviewed materials in the discipline. The use of existing literature, citations, and referencing provides the consideration of existing publications by other authors. The research on the end of life due to technological and pharmaceutical advancements impacts profoundly in elevating the living standards and dignity of individuals in the last moments. The literature indicates that reduction of prolonged death process, sense of control to the patient, and control of pain is significant achievement. Thus, the paper evaluates the best practices, risks involved in ethical considerations of research investigations and incorporation of HIPAA concerns. Consequently, inform developing informed consent components free from plagiarism and ascertains the ethical requirements of research investigations (Stilos et al. 2016).

 

Best Practices and/or Evidence-Based Practice

The best practices in the conduct of research emphasize the importance of plagiarism-free publication. The inclusion of plagiarism in the research investigations comprises of using existing literature without proper citations, referencing, and recognition of the authors’ work (Ho 2016). It is of paramount importance to ensure the recognition of other people’s ideas and contents in your own work. This illustrates the level of ethical consideration and certainty given to the research work. The level of ethical bar met with this kind of research publication comprises of professionalism and utilization the best practices of investigations. The concerns raised through plagiarism free contents are essential to add to existing body of knowledge on the prevalence of better ways used at the end of life care to give patients the most of their last moments in life (Stilos et al. 2016). Furthermore, indicate that their loved ones get to experience extended time and moments together.

The use of existing literature is applied to provide evidence-based practice in the research investigation. The significance of the end of life care in maintaining the dignity of affected persons in the last stages of life through improved technologies and pharmaceutical capacity (Rubin 2015). The research investigations utilize the qualitative approach to assess the ways in which the staff at the emergency department can provide support to the end of life patients leading to better health and dignity preservation. The qualitative approach provides data that is essential in developing evidence-based research by interacting with health care professionals and patients at large (Decker et al. 2015). The data collected provide empirical support to arguments presents in the research topic investigations. Thus, develop evidence-based and informed contents.

 

Identify Risks

The main risks involved in research investigations comprise the use of information regarding the patients’ health history. The patient’s health information must be protected and used in compliance with the law (Edemekong & Haydel 2019). The respect to patients’ privacy and the handling of confidential information is fundamental to the ethical considerations of the research investigations. The patients’ health information is a sensitive matter that infringes on the professional conduct of nurses and researchers (Cohen & Mello 2018). The continuance of research investigations holds the need to utilize the information for the improvement of knowledge without disclosing personal information without due consent. The existing literature informs the need to maintain professional conduct of research without the risk of disclosing health information unnecessarily and unethical practices. Thus, present the thin line between ethical and unethical practices – professional and unprofessional conduct of research investigations impacting to the authenticity and integrity of the work produced from the process.

Address HIPAA and/or FERPA Concerns

The HIPAA defines research in the Privacy Rule as a major component for the furtherance of knowledge development. Research comprises a systematic approach to which investigations are done in “research development, testing, and evaluation to create authenticity and integrity to the contribution of the generalized knowledge in the field” (Michelle & Mello 2018). Authors have the responsibility to maintain high ethical conduct in the use or disclosure of protected health information. This is critical to minimize the risks to the privacy of the patients, respect to the patient’s well-being, and adherence to the rule of law. The capacity to build safe measures in the information use and disclosure is significant to the research investigations which uphold the professionalism of the authors (Wei 2015). Thus, developing a research plan that identifies the information that can or cannot be used or disclosed in crucial to the integrity of generalized knowledge.

Informed Consent Components

The development of informed consent components in research investigations on health care is primarily based on the privacy rule. The privacy rule stipulates the use and disclosure of patients’ information in the development of knowledge and informed research. While the research data is risky to use unprofessionally without ethical considerations, it is important to empirically inform the study and theories developed. Therefore, the covered entities must maintain adherence to the HIPAA guidelines on research conduct (Wei 2015).

The Respectful Death model

The respectful Death ideal was established for development of end of life care. A reverential death is a death that increasingly support the families, patients as well as professionals in the end of life cycle. The model is a progression technique that starts with the establishing of a beneficial connection between the family, the patient together with the incorporated care plan.

Analysis

Human beings have rights focused on values such as parity, worthiness, esteem and autonomy. Human beings are entitled to rights that are centred on principles of, respect, parity and self-sufficiency. An individual that requires individualized kind of care is also eligible to the fundamental rights accorded to other human beings and therefore requires reverence and pride. Decker Lee and Morphet (2015) indicate that there are three proposed interventions that include: expert tutelage and training to the emergency department nurses, provision of a designated area for the patients that allows for the facilitation of a good death and lastly reducing the workload of staff that are assigned the duty of providing individualized care to the patients. Another proposal is the designation of a care provider in the emergency unit whose main obligation would be provision of care to the point that death is imminent.

According to these rights, every individual that requires care is entitled to their rights of care like other human beings. The research indicates that every individual has the need fr care even during the end of life. Nurses have increasingly ensured that end of life care is offered to patients with life limiting diseases. This is important in ensuring that their families as well as the patients have the pride of better care for their loved ones even at the final moments. These interventions have increasingly been improved by technological advancements and the demands for better care in the emergency units. Nurses have been trained on how to offer better end of life care in order to ensure that the patients have pride and reverence in the care given.

Conclusion

End of life care is essential in improving the quality of life for individuals who have had life limiting illness. The nurses and health professionals have a duty to care and offer services to make sure that the dignity of the patient is preserved as they enjoy the last few months of their lives. Many changes and technological advancements geared towards improving the end of life are available to enhance the care strategies. Therefore, end of life care is aimed at saving lives for patients enjoy their final moments.

 

References

Cohen, I. G., & Mello, M. M. (2018). HIPAA and protecting health information in the 21st Century. Jama, 320(3), 231-232

Decker, K., Lee, S., & Morphet, J. (2015). The experiences of emergency nurses in providing end-of-life care to patients in the emergency department. Australasian Emergency Nursing Journal, 18(2), 68-74.

Edemekong, P. F., & Haydel, M. J. (2019). Health insurance portability and accountability act (HIPAA). In StatPearls [Internet]. StatPearls Publishing.

Ho, J. K. M. (2016). Resuscitation versus end-of-life care: Exploring the obstacles and supportive behaviors to providing end-of-life care as perceived by emergency nurses after implementing the end-of-life care pathway. Applied Nursing Research, 29, e7-e13.

Rubin, R. (2015). Improving the quality of life at the end of life. Jama, 313(21), 2110-2112.

Stilos, K., Wynnychuk, L., DasGupta, T., Lilien, T., & Daines, P. (2016). Improving end-of-life care through quality improvement. International journal of palliative nursing, 22(9), 430- 434.