In a training scenario, which action by a hospice team member would prompt supervisor guidance due to potential safety concerns for the patient?

In a training scenario, which action by a hospice team member would prompt supervisor guidance due to potential safety concerns for the patient?

• A. Discussing the meal plan with the patient and family
• B. Noticing a patient has received a very small amount of food and considering feeding tube
• C. Documenting blood pressure changes and informing the family
• D. Administering a higher morphine dose as ordered by the physician

Answer: (B)

In hospice and palliative care, the focus is on comfort and aligning care with the patient’s goals. When a patient is eating very little, and a team member starts to consider placing a feeding tube, this signals a potential safety concern and a shift in the plan that normally warrants supervisor input. Feeding tubes in advanced illness can introduce risks (discomfort, aspiration, infection, and complications) and may not improve quality of life or longevity, depending on the patient’s goals and prognosis. Escalating to supervisor ensures the proposed action fits the goals of care, respects patient/family values, and undergoes appropriate review. The other actions described—discussing meal plans, documenting vital changes and informing family, or increasing morphine only as ordered by the physician—are standard, appropriate elements of ongoing, guided care and do not by themselves indicate a safety-risk escalation requiring supervisor input.

In hospice and palliative care, the focus is on comfort and aligning care with the patient’s goals. When a patient is eating very little, and a team member starts to consider placing a feeding tube, this signals a potential safety concern and a shift in the plan that normally warrants supervisor input. Feeding tubes in advanced illness can introduce risks (discomfort, aspiration, infection, and complications) and may not improve quality of life or longevity, depending on the patient’s goals and prognosis. Escalating to supervisor ensures the proposed action fits the goals of care, respects patient/family values, and undergoes appropriate review.

The other actions described—discussing meal plans, documenting vital changes and informing family, or increasing morphine only as ordered by the physician—are standard, appropriate elements of ongoing, guided care and do not by themselves indicate a safety-risk escalation requiring supervisor input.