Article Content

HPNA Launches New Clinical Practice Forum

The HPNA has announced the first in a series of annual clinical practice forums, the 2007 Managing Non-Cancer Patients Forum, which is to be held September 7 and 8, 2007, at the Hilton Pittsburgh. The Forum is designed for practicing hospice and palliative RNs and any other professional nurses interested in palliative nursing management for non-cancer patients. The purpose of the forum is to demonstrate best nursing practices managing four disease areas: renal, cardiac, pulmonary, and dementia.


At the end of the 2007 Forum, the participant will be able to:


* Define the issues of professionalism.


* Identify concerns for maintaining a professional image.


* Describe ways to provide self-care for the nursing professional.


* Recognize clinical assessments and treatments for two of the four distinct non-cancer diagnoses.


* Discuss the diagnoses and treatment options for renal/cardiac/pulmonary/dementia patients.


* Discuss the unique challenges for medication management in these diagnoses.


* Describe management of difficult symptoms in these non-cancer diagnoses.


* Review evidence-based practice for management of renal, cardiac, pulmonary, and dementia patients.


* Establish networking relationship with clinical colleagues.



The Preconference on Friday, September 7, offers two events providing up to 3.5 contact hours: a workshop on "Navigating Through Establishing/Updating Goal of Care" by Virginia Valentine, MS, RN, CHPN(R), which provides a discussion of the new 2008 conditions of participation requiring stronger documentation of the measurement of care delivery; and a workshop on "B.O.A.T.I.N.G. (Before Offering Another Treatment Identify New Goals)," a one-act educational play by Jill Bixby, NP, MA, BSN, that provides insight into the benefits and burdens of treatment at EOL.


Main conference events offer up to 10.5 contact hours. Presenters include Judy Bartel, APRN, BC-PCM, Meg Campbell, APRN, BC-PCM, Connie Dahlin, APRN, BC-PCM, Beth Fahlberg, ARPN, MN, Betty Ferrell, PhD, FAAN, Linda Gorman, APRN, BC, MN, CHPN(R), OCN, Judy Lentz, RN, MSN, NHA, Joe Lyons, Janet Snapp, MSN, OCN, CHPN(R), Dena Jean Sutermaster, RN, MSN, CHPN(R), and Charles Wellman, MD. In addition to the educational sessions, poster sessions, break-out sessions, and a reception are planned. More information, including a link to conference registration information and brochure, can be found on the HPNA Web site ( or by calling the HPNA national office at 412-787-9301.


NQF Releases New Palliative Care Framework Document

To standardize palliative care practices for the growing number of people with life-threatening or debilitating illness, two national initiatives have defined the core domains of palliative care: the National Consensus Project (NCP) for Quality Palliative Care and the National Quality Forum's (NQF's) Framework and Preferred Practices for a Palliative and Hospice Care Quality Project. Since 2005, the NCP's administrative home has been at the national office of the HPNA in Pittsburgh, PA, and the NQF is headquartered in Washington, DC. The NCP released its "Clinical Practice Guidelines for Quality Palliative Care" in April 2004. Since the time of that initial release, great progress has been made toward the goal of standardizing palliative care practices across healthcare providers. In February 2007, using the Guidelines as a primary resource, the NQF released "A National Framework for Palliative and Hospice Care Quality Measurement and Reporting."


Because the NQF Framework is based largely on the NCP's Guidelines, the two documents share much in common:


* Both attempt to formalize the concept of palliative care by providing extended descriptions and definitions differentiating palliative from other types of care.


* Each structures the theory and practice of palliative care into eight domains: (1) structure and process of care, (2) physical aspects of care, (3) psychosocial and psychiatric aspects of care, (4) social aspects of care, (5) spiritual, religious, and existential aspects of care, (6) cultural aspects of care, (7) care of the imminently dying patient, and (8) ethical and legal aspects of care.



Because each document has a function unique to the mission of its sponsoring organization, however, each also differs in significant ways:


* The NQF Framework is the first step in a process through which rigorous, quantifiable internal and external quality indicators will be developed. The NCP Guidelines, in contrast, include extensive background on the history and philosophy of palliative care and are carefully referenced to the evidence base from which they are drawn.


* The NCP Guidelines are intended to provide guidance across a range of palliative care delivery settings. The NQF Framework provides a concise structural definition of quality palliative care as prerequisite for the identification and testing of quality measures.


* The NQF Framework will lead to palliative care standards, with implications for reimbursement, internal and external quality measurement, regulation, and accreditation.



The NCP Guidelines can be obtained on the Web at or by phoning the NCP Project Coordinator, Ken Zuroski, at 412-787-1002. A summary of the NQF Framework, including the preferred practices for palliative and hospice care, can be downloaded from


A CD with the audio from "Will You Help Me Die?" is available for purchase from HPNA. It was recorded when it was presented as a preconference at the AAHPM/HPNA Annual Assembly in Salt Lake City, UT on February 14, 2007. This 4-hour workshop deals with the most difficult request that we in palliative and hospice care may hear. This session explored the ethical and legal frameworks, which are critical to practice, and assisted learners in clarifying personal values as we examined actual cases from both adult and pediatric fields. Participants learned practical ways to ensure compassionate responses to the request for hastened death.


The two most recent Compendiums for Treatment of End-Stage Non-Cancer Diagnoses are "HIV/AIDS" and "Dementia." These books cover the pathophysiology, assessment, and interventions of the disease and include psychological, economic, and ethical issues and research opportunities.


The "Core Curriculum for the Advanced Practice Hospice and Palliative Nurse" is currently available. The goal of the curriculum is to provide a foundation of knowledge from which APNs can practice palliative care. This book is divided into three sections: (1) an introduction to the roles, advanced skills, and issues facing APNs in hospice and palliative care, (2) management of complex life-limiting, progressive illnesses, and (3) special clinical issues. This curriculum is also a resource for any APN working with patients with life-limiting illness.


"Quality of Life Matters(R) When Facing a Life-Limiting Illness," a unique 14-page booklet, is an ideal way to educate patients and families about the choices available to them when facing a life-limiting illness. The booklet explains palliative care, power of choice, patient rights, and nursing's role in advocacy and development of plan of care.


"Conversations in Palliative Care," presented in a question-and-answer format, is a comprehensive resource built on a foundation of the basics of defining palliative care and hospice, communicating with patients and families and with other professionals, spiritual care, bereavement, and more. Nurses who are not familiar with the field of palliative care will find this text a helpful orientation tool to key principles for application to families and patients in care settings such as emergency rooms, intensive care units, general medical areas, and long-term care facilities. To nurses who work in the area of hospice and/or palliative care, this book offers unique features, including topics such as nutrition, physical therapy, and occupational therapy. The "how to" sections of the text also discuss starting a palliative care program.


Catch Up with Key to Your Heart Cases

The popular Key to Your Heart cases are still available for a $20.00 donation. Used for giving to a special someone or as a special thank you, the heart-shaped metal cases are gold tone and enamel, studded with "diamonds," and topped with a blue butterfly. They come with three keys inside that declare your friendship and love. The cases are shipped to you in a white satin-lined 3" square box made of light aqua handmade paper with a self-bow in a complementary light celery color. Both the box and the heart case are inscribed with the HPNF logo. See a photo on the HPNF Web site ( Orders can be placed online or by calling HPNF at 412-787-9301.


2007 Member Appeal

The Foundation is celebrating the 21st year of HPNA with our second annual member appeal. Early results show that our nurse-members believe in the work they do and the work of the Foundation, because responses are coming in rapidly. The outcome of the campaign is partly to provide funds for 21 awards, grants, and scholarships to you, the membership. If for some reason you were not included in the mailing and would like to contribute specifically to this member appeal, please contact the Director of Development, Laura Ristau, at 412-787-9301 or [email protected].


ACHPN(R) and CHPN(R) Examination Programs Accredited with American Board of Nursing Specialties!

NBCHPN(R) is proud to announce that they have successfully fulfilled the American Board of Nursing Specialties accreditation requirements for the ACHPN(R) program and have fulfilled the reaccreditation requirements for the CHPN(R) program. Both accreditations are valid through February 2012. NBCHPN(R) continues the conversion from paper-and-pencil exams to computer-based testing (CBT) beginning in 2008. We have included some commonly asked questions about CBT.


Will the application process be the same for CBT as when it was paper and pencil?

Yes, the application process will remain the same with CBT with a few modifications. Candidates still have the option to either apply (register) for the exam online or they can mail in a paper application. Application deadlines differ for online applications versus paper applications, so be aware of the deadlines for your chosen method of application. Group paper applications from hospices will be accepted; however, group checks must be marked to indicate which individuals are covered by that check, and each individual candidate is responsible for "scheduling" his or her examination. Once applications are received and processed by AMP, the individual candidates will receive notification that they are eligible for the exam and need to schedule their examination. Candidates can schedule online at or call AMP at 1-888-519-9901.


Will the Americans with Disabilities Act (ADA) accommodations still be available with CBT?

Yes, all ADA accommodations will still be available with CBT just as they were with the paper-and-pencil exam.


Where do I go to test?

The CBT will be available at more than 150 AMP assessment centers throughout the United States, many of which are located within H&R Block offices. Testing is not available online or through a home computer. Depending on the location, approximately four carrels (designated computer desk space) will be available for testing at the test site location. Each carrel has modular walls on both sides of the candidate to allow for privacy. Alternate test sites will no longer be available.


What if I have a computer issue during the exam?

Just as with the paper-and-pencil exam, proctors are available at all times for technical assistance. The proctors are not able to assist with the content of the exam, but if there is a computer issue they are trained to react accordingly. In the event of a power failure, a proctor will assist you with how to proceed. Monitored breaks will be available if needed; however, testing materials are not permitted to leave the testing area.


Do I need to have previous computer experience to be able to test?

Candidates need not have prior computer experience to use CBT. At the beginning of the test, each candidate receives a brief introductory tutorial that instructs him or her on how to use the computer to answer the questions and review responses. No typing skills are needed. As each question appears on the screen, the candidate uses the computer mouse to highlight and confirm the response selected. A help screen is always accessible, and a proctor is always available to answer questions regarding navigating throughout the exam.


How is the test formatted?

The CBT is set up in a linear format. In a linear format the candidate answers a predetermined number of questions. The exam questions do not become increasingly more difficult based on answers to previous questions. Candidates are able to move forward and backward throughout the exam, bookmark questions for return and review, and change answer selections as many times as necessary during the allotted time before clicking the finish and exit button of the exam.


Look for More Information about CBT in future publications and on our Web site,!