Every year the Board of Directors of the Hospice and Palliative Nurses Association (HPNA) undertakes the development of two to three position statements. Each statement addresses a professional, clinical, or ethical issue of importance in end-of-life nursing.
The position statement includes the Board's position, which may support, oppose, or clarify the issue, background information that briefly explores the issue and provides rationale for the Board's position, definitions of terms used in the statement, and references.
The statements use current and seminal literature and expert opinion from within and outside HPNA to inform the position of the Board. To ensure that position statements reflect current knowledge and practice, existing position statements are reviewed at least every 3 years. Earlier review may be necessitated by changes in law, public policy, or the evidence base of practice. Occasionally, HPNA may endorse the position statement of another association or organization that relates to end-of-life care. This was the case with the American Nursing Leaders' position statement on the Advanced Practice Nurses' Role in Palliative Care.
Between 2001 and 2005, the Board developed 11 position statements. Most of the initial position statements address clinical and ethical issues commonly encountered in end-of-life care. These included assisted suicide, the use of complementary therapies, the importance of pain management, the use of opioids at end of life, and the roles of palliative sedation and artificial nutrition and hydration.
More recent position statements focus on concerns relevant to continued growth of the specialty of hospice and palliative nursing. In 2003, the Board issued a statement on the Shortage of Registered Nurses in support of the Joint Commission on Accreditation of Healthcare Organizations recommendations to address the nursing crisis.
A statement on the Value of Professional Nurse in End-of-Life Care quickly followed. The newest position statement affirms the Value of the Nursing Assistant in End-of-Life Care. A key feature of these two statements is the need for competent, compassionate nursing care at all levels to meet the wide spectrum of needs at the end of life.
Because all members of the nursing team contribute to quality care, and certification has been linked to improved patient outcomes, the Board issued a statement on the Value of Nursing Certification for all nursing team members, encouraging individual clinicians to pursue certification and employers to support certification.
The use of an evidence base to guide practice and establish clinical guidelines also supports quality care. The Board statement on Evidence-Based Practice advocates the use of evidence of best practice to guide clinical care, the development of infrastructures to support such practice, and research to advance the evidence base.
Position statements are the official view of HPNA. Knowledge of the HPNA position may help you with clinical decision making, practice issues in your own setting, role development, creation of standards of care and policies, and the education of peers, colleagues, employers, patients, and the public. New position statements are published in the Journal of Hospice and Palliative Nursing, but position statements also can be viewed and downloaded from the HPNA Web site at http://www.hpna.org/posi-tions.asp.