Authors

  1. MARTINEZ, JEANNE M. RN, MPH, CHPN

Article Content

Palliative care focuses on patients requiring symptom management and support for advanced disease, and at the end of life. Hospice and palliative nursing is the care of patients and their families, emphasizing their physical, psychosocial, emotional, and spiritual needs (Martinez et al., 2000).

 

The NBCHPN has certified RNs with the CHPN credential since 1993. NBCHPN developed certification in hospice and palliative care for nursing assistants in 2002 (Martinez, 2003), and for advanced practice nurses in 2003. The certification exam for LPNs and LVNs was launched in September 2004.

 

Defining Scope and Standards

Any valid certification process begins with a job analysis or Role Delineation Study to identify the scope and standards of a specialty practice (Cogdill & Fabrey, 2003). LPNs and LVNs nationwide were surveyed in a variety of palliative care and hospice practice settings, to define their patient care tasks. A representative panel of hospice/palliative care experts (RNs and LPNs) then analyzed the survey results.

 

The panel prioritized tasks from the surveys and compared them to palliative care standards. These tasks provided the basis for developing the scope, standards, and competencies defining LPN/LVN palliative care practice and a content outline used as a blueprint for each exam. This process was guided by the testing agency Applied Measurement Professionals, Inc. (AMP) (Cogdill & Fabrey, 2003).

 

The Certification Exam

Each year, the NBCHPN Board of Directors appoints an Exam Development Committee (EDC). EDC is responsible for all aspects of the exam. The LPN EDC consists of expert LPN/LVNs and certified RNs from across the United States, representing hospice, long-term care, home care, and acute care (Martinez, 2002). AMP oversees exam administration, scoring, and test outcomes reporting under the policies established by the NBCHPN Board.

 

Eligibility

Candidates who have an active LPN or LVN license are eligible to take the exam. A minimum of 2 years' practice in a hospice or palliative care setting is strongly recommended. HPNA members receive a discount on the exam application fee.

 

Candidates who successfully pass the exam receive the CHPLN credential. The LPN/LVN certification is valid for 4 years after which time candidates are required to recertify in order to maintain their specialty credential. The exam is offered twice each year, in March and September, at over 40 sites nationwide. Detailed information is available by calling (888) 519-9901 or visiting http://www.nbchpn.org.

 

ACKNOWLEDGMENTS

The author thanks The Fan Fox and Leslie R. Samuels Foundation for its partial grant support provided for the development of the LPN/LVN certification in hospice and palliative care.

 

Licensed Practical/Vocational Nurse Certification Examination: Detailed Content Outline

 

1. Patient Care: End-Stage Disease Process in Adult Patients

 

2. Patient Care: Pain and Comfort Management

 

3. Patient Care: Symptom Management

 

4. Patient Care: Treatments and Procedures

 

5. Care of Patient, Family and Others

 

6. Patient and Family Education and Advocacy

 

7. Interdisciplinary and Collaborative Practice

 

8. Practice Issues

 

REFERENCES

 

Cogdill, K. S., & Fabrey, L. J. (2003). A National Practice Analysis of the Hospice and Palliative Licensed Practical/Vocational Nursing Professional. Kansas City, KS: Applied Measurement Professionals, Inc. [Context Link]

 

Martinez, J. (2002). What is the Exam Development Committee?Journal of Hospice and Palliative Nursing, 4. [Context Link]

 

Martinez, J., Wagner, S., Groenwald, S. L., Frogg, M. H., Goodman, M., et al. (2000). Cancer Nursing: Principles and Practice. (5th Ed.). Boston: Jones and Bartlett. [Context Link]

 

Martinez, J. M. (2003). Hospice and palliative care specialty certification for nursing assistants. Home Healthcare Nurse, 21, 193-194. [Context Link]

Study Reveals Technology Advancements Improve Nursing Workload and Retention Rate

 

According to results from a recent study by the Pennsylvania Homecare Association (PHA) and Penn State University (PSU), the use of telehealth by patients receiving home health care can increase nurses' productivity while maintaining the same quality of care.

 

Thirty-four home health agencies from 48 counties throughout the Commonwealth participated in the project; 23 used telehealth systems, whereas the remaining 11 served as a comparison group. Dr. Kathryn Dansky, an associate professor for PSU's Department of Health Policy and Administration, led the 2-year-long study intended to determine how telehealth can be used to address work-force issues in the home healthcare industry.

 

The most recent data generated by this study demonstrate that the use of telehealth in homecare helps agencies maximize resources and see more patients. Agencies that have sicker patients and more significant amounts of travel time are able to see up to 75% more patients if this technology is used.

 

This study also assessed home health nurses' attitudes towards their jobs and their response to telehealth. Survey results are summarized below; item responses ranged from 1 (low) to 5 (high).

 

[black small square]Job satisfaction continues to be high, with an average score of 4.18.

 

[black small square]Nurses' involvement in telehealth activities is low, with an average score of 1.9. Most nurses report that they perform telehealth activities less than once a week, which could be attributed to the fact that many agencies use a small core group of nurses to perform these activities.

 

[black small square]The average score for perceived usefulness of telehealth is 3.57. The longer the home health agency has been using telehealth, the more useful the nurses perceive it to be.

 

[black small square]Overall, nurses indicate that organizational support for telehealth is in the mid-range, with an average score of 3.76.

 

 

To examine the relationship between telehealth and nurse retention rates, a measurement of the annual turnover rate for each the 34 participating home health agencies was taken. Results show the following:

 

-Voluntary turnover rates for RNs in this sample of home health agencies decreased from 17% (year 1) to 13.4% (year 2).

 

-The lowest turnover rates were found in the home health agencies that have implemented telehealth-estimated at 11% a year, compared to almost 19% for home health agencies that do not use telehealth.

 

 

Combining the results from the survey analysis and turnover data, the study concluded that telehealth does seem to have an effect on nurses remaining on the job, although it may be indirect. For more information about the PHA telehealth project, please visit http://www.pacareathome.org or call (800) 382-1211.