MODULE 3 MODULE 4 MODULE 5 MODULE 2 ETHICS ISSUE 3: Ethical Practices in End-of-Life Care—Other 2. Ethical 3. Ethical 4. Best 5. Metric 6. Current 7. Reality 8. 9. Refined 1. Ethics Standard Standard Practice Ethics Check Goal Improvement Issue Source(s) Description(s) with Practice Goal “Should” “Is” Exclusions Nursing staff American Patients should be Physicians Numerator: Current practice 1. Starting on the acute Medical able to trust that their should was determined Point Number of care medical physician will to round by a patients floor have Statement to care for them daily on dying health record who were reported that on when dying. If a medicine review of 5 daily by a they are Care must transfer that are patients per physician while an the patient in order to waiting to be physician waiting to be Facility increasingly provide quality care, discharged to discharge to discharged to 2. Seriousness on difficult time that physician should another care another care another care persuading make every setting [unless setting. setting of physicians to effort to continue patient does Information Currently, 30% of ____________ round on to visit the patient not wish to physicians round patients with regularity, and have his/her Denominator: on dying waiting to be institutional systems physician 3. Environment at least Total number discharged to should try to round on a once per day of dying another care this. daily basis]. waiting to while the patient setting—and Facility Policy states is waiting to be be discharged that patients that patients should discharged to to another care continue to receive the same another care setting ask when the care by all treating 4. Challenge doctor will be providers, and in to visit and on acute care Method: wonder why floors should be seen Observation the doctor daily. has stopped Sample size: coming every Exclusion(s): 20 patients day. Patient does not wish Time frame for to have his/her data round on a 5 days daily basis.
MODULE 2 MODULE 3 MODULE 4 MODULE 5 ETHICS ISSUE 3: Ethical Practices in End-of-Life Care—Other 1. Ethics Issue 2. Ethical Standard Source(s) 3. Ethical Standard Description(s) with Exclusions 4. Best Practice “Should” 5. Metric 6. Current Ethics Practice “Is” 7. Reality Check 8. Goal 9. Refined Improvement Goal Nursing staff on the acute care medical floor have reported that they are an increasingly difficult time persuading physicians to round on patients waiting to be discharged to another care setting—and that patients continue to ask when the doctor will be in to visit and wonder why the doctor has stopped coming every day. American Medical Statement on Care Facility on of Information Patients should be able to trust that their physician will to care for them when dying. If a must transfer the patient in order to provide quality care, that physician should make every effort to continue to visit the patient with regularity, and institutional systems should try to this. Facility Policy states that patients should receive the same care by all treating providers, and on acute care floors should be seen daily. Exclusion(s): Patient does not wish to have his/her round on a daily basis. Physicians should to round daily on dying medicine that are waiting to be discharged to another care setting [unless patient does not wish to have his/her physician round on a daily basis]. Numerator: Number of patients who were daily by a physician while waiting to be discharged to another care setting ____________ Denominator: Total number of dying waiting to be discharged to another care setting Method: Observation Sample size: 20 patients Time frame for data 5 days Current practice was determined by a health record review of 5 patients per physician discharge to another care setting. Currently, 30% of physicians round on dying at least once per day while the patient is waiting to be discharged to another care 1. Starting Point 2. Seriousness 3. Environment 4. Challenge