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with therapeutic orders from the patient’s attending physician and/or the hospice medical director and the hospice interdisciplinary team. This might include hospice standing orders for symptom management (for example, control of nausea and vomiting, bowel management) and other palliative care measures such as oxygen, as needed.The next section deals with Education (PF). Standard PF.2 reads:The patient and family receive education and training specific to the patient’s assessed needs, abilities, and readiness, as appropriate to the care and service provided by the organization.As part of it’s overall education plan, a hospice develops written teaching materials geared toward family members and caregivers on caring for a hospice patient in the home. The teaching materials

address such aspects as medication administration, caring for a bed bound patient, skin care, nutrition, signs and symptoms of impending death, and the preparation for and handling of a death in the home. Hospice interdisciplinary team members also teach the family about such issues as communication and coping styles; the psychosocial and spiritual needs of dying people such as “needing permission to die,” “saying good-bye” ; letting go of the patient; and managing grief and loss.Though there are other important sections in the manual, because of time limitations, I am going to cover only one more section which is Surveillance, Prevention, and Control of Infection. IC.1 reads:Processes are in place to reduce risks for infections in patients and staff members.This is

implemented by determining that the surveillance of infections among patients and staff will include tuberculosis, hepatitis, and HIV, as well as new incidences of central venous catheter infections or wound infections. Surveillance identifies a trend of staph infections among patients with pressure ulcers, and planning includes the identification of mechanisms both to prevent skin breakdown and prevent infections in acquired open wounds.This section of the manual is the real meat of keeping in line with OSHA guidelines. In hospice care, the control of bloodborne pathogen exposure is utmost and it is required that there be an exposure control plan that is to be read by employees and signed as having been read.Complying with OSHA guidelines is looked at very closely by the risk

management committee who keeps a sharp eye on Home Health because so many potentially dangerous situations arise when entering a patient’s home. Cost Containment Issues:Within hospice, there is not a too big of a worry on cost of care. Because of Medicare’s Hospice Plan paying 100% of the patient’s bill, the patient has less to worry about. As in most other areas of the hospital, however, risk management and the potential for loss of dollars is the major concern. As I mentioned, special care must be taken when entering a patient’s home and additional things need to be looked at such as slippery walks, loose dogs, and traffic when getting to the patient’s home.As you can tell, hospice is a very complex, very necessary service which has many rewards. I hope I have helped

you to have a better understanding of this department and the services they provide. In your packet you will find several brochures which you may want to look at in the future.Are there any questions?