Purpose/Objectives:
To establish a hospital-wide inpatient palliative care consultation program utilizing a collaborative approach between a clinical nurse specialist (CNS) and physician.
Significance:
To provide a choice of palliative care to individuals with advanced complex illness who are facing disruption of their perceived quality of life. To act on the vision for culture change in an academic community Magnet hospital, valuing the expertise of the (CNS) as consultant and advanced practice nurse (APN) and giving a voice to other CNSs to reclaim their advanced practice roles.
Design/Background/Rationale:
The advancement of technology often prolongs death instead of prolonging life. Individuals with advanced complex illness need adequate information and time before making treatment choices. The CNS as consultant and clinical expert is able to facilitate thoughtful conversations about treatment choices. The CNS is able to navigate across system lines and collaborate with varied disciplines.
Methods/Description:
The program was piloted on one geriatric unit, with staff education designed and provided by the CNS. Consults were collaboratively completed with the CNS and physician. After working through concerns and flow issues, the program moved to other units.
Findings/Outcomes:
Hospital-wide implementation and acceptance of palliative care. Preliminary data show decreased length of stay and costs per case with improved staff and patient satisfaction. Hospital's increased awareness of CNS as APN.
Conclusions:
The CNS has the ability to work collaboratively and cross the cultural divides of institutions. The CNS promotes the image of nursing and is able to educate others to improve patient outcomes. The CNS as consultant is able to provide support to the patient and family.
Implications for Practice:
Working within the three spheres of CNS practice, the CNS maintains excellence in practice, educates patients and staff, and promotes system change. Other CNSs within the network have a vision for change within their specialties. The success of this program brings value to the role of the CNS. The voice of the CNS is necessary to provide nursing excellence for those in our charge.
Section Description
The journal is proud to share the student abstracts accepted for poster presentation at the 2009 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.