1. Asper, Maureen MSN, RN, CHPN

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The purpose of this presentation was to identify a need for palliative care services in the hospital and to discuss developing an inpatient palliative care service. At the end of this presentation, the learner will be able to describe 5 clinical nurse specialist (CNS) activities of an inpatient palliative care service that would benefit patients, staff, or the institution and to classify the benefits into the spheres of influence.



Inpatient palliative care programs increase staff knowledge, decrease pain and other uncontrolled symptoms, and decrease undesired tests, resulting in increased patient satisfaction through better patient care and a stronger financial picture for the institution.



Today, more people are dying in the hospital than at any time in the past. With today's technology, more life-prolonging efforts are given to patients at the end of a natural lifespan without appreciable benefit to the patient, resulting in unnecessary suffering and costs.



The CNS is a perfect change agent to introduce palliative care as an inpatient hospital service. An inpatient palliative care service offers expert symptom management, helps patients and families cope with a life-threatening illness, enhances the hospital's financial picture, and educates staff.



Patients and families benefit from the CNS's knowledge to help them understand the disease process, treatments, and expected projection of disease and from assistance in making better decisions regarding care. The patient enjoys expert management of symptom control, fewer undesired tests or medications ordered, and support during a difficult phase of life. The staff benefits from additional training, and the monies saved from a palliative care program will assist the institution during the shrinkage of resources.



With today's healthcare focus on customer service, the inpatient palliative care program will address difficult symptoms and will work closely with the patient and family during difficult discussions of advance care planning, including treatments, preparing for changes, and withdrawal of life support. As an expert, the CNS will enhance the staff skills and lighten the institution's financial burden in delivering healthcare.


Implications for Practice:

The inpatient palliative care program with a CNS positively affects patients, families, staff, and the institution, resulting in better customer satisfaction, more knowledgeable staff, and better financial outcomes.


Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.


Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.


The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.