Palliative Nursing Summit

On May 12, 2017, the Hospice and Palliative Nurses Association, in conjunction with our two affiliated organizations, the Hospice and Palliative Credentialing Center and the Hospice and Palliaitve Nurses Foundation, convened a national Palliative Nursing Summit in Washington, D.C., hosted by the George Washington University School of Nursing. Funding was received from the Milbank Foundation and the Hospice and Palliative Nurses Foundation. The objective of the Palliative Nursing Summit was to develop a collaborative framework for nursing practice across nursing specialties related to three key areas of primary palliative care: communication and advance care planning, transitions and coordination of care, and pain and symptom management. The goal was to enhance patients' access to palliative care whenever or wherever they needed it. Twenty-seven nursing specialty organization, representing over 600,000 members, participated in the event.

Following the development of the Palliative Nursing Summit Summary Report, two project teams were created, with one addressing the nurses' role in advance care planning and the other focusing on pain and symptom management, especially issues related to the opioid crisis.  All nursing organizations who participated in the summit were invited to continue to collaborate on these two teams.  More information about the work of the teams is listed below.

Continuing Initiatives from the Palliative Nursing Summit

In March of 2018, the two teams began meeting to work on these initiatives.  The Pain Project Team divided into four separate work groups, while the Advance Care Planning Project Team is organizing their work around three different initiatives. The layout of the Palliative Nursing Summit project structure is shown below. 

There are 17 organizations who participated in the Palliative Nursing Summit who are continuing to collaborate on one or both project teams, as well as two additional organizations who have joined, the National Black Nurses Association (NBNA), and VITAS. We appreciate the ongoing commitment to these project teams.



Pain Project Team

Polly Mazanec is serving as chairperson of this project team, which in conjunction with HPNA education staff, presented a free webinar on May 22, 2018, titled “Every Nurse’s Role in Safe and Effective Opioid Pain Management.” Dr. Judy Paice and Patrick Coyne led the webinar, which was offered to members of all the nursing organizations who participated in the summit and other targeted audiences. Over 1,000 individuals registered for the webinar, more than 500 participated in the program, and participants were awarded CE credits (1.25). 

Organizations collaborating on this team include the American Association of Critical Care Nurses (AACN), American Association of Nurse Practitioners (AANP), American Nurses Association (ANA), American Psychiatric Nurses Association (APNA), American Society of Pain Management Nurses (ASPMN), Association of Pediatric Hematology/Oncology Nurses (APHON), Association of Rehabilitation Nurses (ARN), Emergency Nurses Association (ENA), Gerontological Advanced Practice Nurses Association (GAPNA), Hospice and Palliative Nurses Association (HPNA), Infusion Nurses Society (INS), National Association for Home Care and Hospice (NAHC), National Association of Clinical Nurse Specialists (NACNS), National Association of Pediatric Nurse Practitioners (NAPNAP), National Black Nurses Association (NBNA), Nurses Organization for Veterans Affairs (NOVA), Oncology Nursing Society (ONS), and VITAS.  The project team is divided into the four work groups listed below.  

Clinical Practice

This group is focusing on nurses’ knowledge of appropriate equianalgesic conversions. The work group has decided to write a manuscript for the American Journal of Nursing (AJN) in order to reach a large population of nurses caring for those with serious illnesses. The project team is also interested in evaluating pain assessment needs related to nonverbal patients. 

Education

The work group’s focus is on assisting nurses with pain assessment and asking probing questions to address fears and concerns of patient and families about pain medications. The team is planning another webinar in November 2018 which will showcase three video clips, role-modeling nurses asking these assessment questions, and responding to the patient/family responses. The ASPMN is supporting this initiative by providing the videotaping during their September conference. Amy Haskamp (APHON), Vanessa Battista (NAPNAP), and Ellyn Schreiner (ASPMN) will lead the webinar in conjunction with the HPNA education staff. 

Research

The group’s objective is to focus on providing bedside nurses with evidence-based practice for patients with serious illnesses. A manuscript, focusing on the care of the patient with comorbid substance use disorder and serious illnesses, will be written for AJN for 2019 publication. Dr. Judy Paice is leading the writing of this manuscript.  

Regulatory/Advocacy

This work group authored an advocacy letter that was sent to Congress on July 25, 2018, related to the opioid issue, the need for appropriate access to care, support for access to and payment for nonpharmacological pain therapies, and continued research. 

All nursing organizations who participated in the Palliative Nursing Summit, and the two new collaborating organizations, were provided with the opportunity to endorse the letter.  Twenty organizations representing over 715,000 nurses and other healthcare professionals endorsed the letter. Those organizations include the Academy of Medical Surgical Nurses (AMSN), Academy of Neonatal Nursing (ANN), American Association of Critical Care Nurses (AACN), American Association of Neuroscience Nurses (AANN), American Holistic Nurses Association (AHNA), American Nephrology Nurses’ Association (ANNA), American Nurses Association (ANA), American Psychiatric Nurses Association (APNA), American Society of Pain Management Nurses (ASPMN), Association of Pediatric Hematology/Oncology Nurses (APHON), Association of Rehabilitation Nurses (ARN), Gerontological Advanced Practice Nurses Association (GAPNA), Hospice and Palliative Nurses Association (HPNA), Infusion Nurses Society (INS), National Association of Clinical Nurse Specialists (NACNS), National Association for Home Care and Hospice (NAHC), National Black Nurses Association (NBNA), Oncology Nursing Society (ONS), VITAS, and Wound, Ostomy, and Continence Nurses Society (WOCN). 
 

Advance Care Planning Project Team

JoAnne Reifsnyder and Todd Hultman are serving as co-chairs of this project team.  Organizations collaborating on the ACP Project Team include American Association of Nurse Practitioners (AANP), Association of Pediatric Hematology/Oncology Nurses (APHON), Emergency Nurses Association (ENA), Gerontological Advanced Practice Nurses Association (GAPNA), Hospice and Palliative Nurses Association (HPNA), National Association of Clinical Nurse Specialists (NACNS), National Association of Pediatric Nurse Practitioners (NAPNAP), National Black Nurses Association (NBNA), Oncology Nursing Society (ONS), VITAS, and the Wound, Ostomy, and Continence Nurses Society (WOCN). Team Initiatives that will be addressed sequentially are as follows:

ACP Campaign for Nurses

The group is planning conversations with the communications staff from the Palliative Nursing Summit organizations to help develop strategies to create an ACP Campaign specifically for nurses. The plan is to sponsor a campaign targeted at nurses, which will last from Thanksgiving to New Years, and then follow up with a public campaign at a later date.   

Standardized ACP Education Program for Nurses

The team will develop a resource guide for nurses regarding the advance care planning process.

Business Case for Nurses Related to ACP

The co-chairs are currently working on writing and publishing an article focused on the business case that supports the ACP process as a role of all registered nurses. The authors have been identified to work on the article and the initial outline has been drafted.  If your organization has completed projects or initiatives to add to this list, please contact us.
 

Related Achievements

The following are achievements by participating organizations at the Palliative Nursing Summit who support at least one of the three focus areas, or from other organizations about the topics discussed. If your organization has completed projects or initiatives to add to this list, please contact us. 
 

 

Key Summit Documents and Resources (updated)

Documents

Resources

Palliative Nursing Summit Videos



History of the Palliative Nursing Summit (2017)

There are more than 4 million nurses in the United States. Individually and collectively, who make significant contributions daily to improve both the health of individuals and the healthcare of our country. Access to quality health care continues to be a national agenda priority, especially for people with a chronic serious illness and their families. National initiatives, including those listed in the resources below, have helped to set the stage by identifying significant opportunities to enhance our care delivery models and systems. The time is right for the nursing community to create a collaborative agenda to focus on how nurses lead and transform care for individuals and their families who are facing serious illness. 

A Collaborative Agenda Will Drive Action

Nurses across most nursing specialties incorporate basic elements of primary palliative care into their practice. Nursing has a unique opportunity to work collectively, to develop a shared framework and consensus agenda to the integration of primary palliative care across all nursing specialties. The Palliative Nursing Summit focused on three aspects of primary palliative care:

  • Communication and advance care planning. The facilitation of advance care planning discussions is inherent in palliative nursing practice, through which nurses advocate for patients, support self-determination, and integrate patient and family values into the plan of care.
  • Coordination/transition of care. The deliberate organization of patient care activities to facilitate the appropriate delivery and transition of health care services across disciplines and settings.
  • Pain and symptom management.  Prevention and treatment of pain and symptoms of disease, including side effects of treatment and psychological, social, and spiritual care related to a disease or its treatment.
The summit participants worked in small groups led by a nursing content expert in each of the three focus areas. These national nursing experts included Mi-Kyung Song, PhD, RN, FAAN (communication/advance care planning), Gerri Lamb, PhD, RN, FAAN (coordination/transitions of care), and Judith Paice, PhD, RN (pain and symptom management). The work and findings of the summit were disseminated through publications and presentations, with four articles published in the February 2018 issue of the Journal of Hospice and Palliative Nursing (JHPN). The September 2017 HPNA Clinical Practice Forum (advancingexpertcare.org/clinical-practice-forum) also featured a session on the findings of the summit.

HPNA appreciates the support of the Milbank Foundation, Hospice and Palliative Credentialing Center, and Hospice and Palliative Nurses Foundation., whose helped make the Palliative Nursing Summit a reality. 

Attending Organziations at the May 2017 Summit

  • Academy of Medical-Surgical Nurses (AMSN) – 11,350 members
  • Academy of Neonatal Nursing (ANN) – 6,000 members
  • American Academy of Ambulatory Care Nursing (AAACN) – 3,000 members
  • American Association of Critical Care Nurses – 100,000 members
  • American Association of Neuroscience Nurses (AANN) – 3,400 members
  • American Association of Nurse Practitioners (AANP) – 70,000 members
  • American Holistic Nurses Association (AHNA) – 4,500 members
  • American Nephrology Nurses Association (ANNA) – 10,000 members
  • American Nurses Association (ANA)
  • American Psychiatric Nurses Association (APNA) – 10,000 members
  • American Society for Pain Management Nursing (ASPMN) – 1,300 members
  • Association for Radiologic and Imaging Nursing (ARIN) – 2,000 members
  • Association of Pediatric Hematology/Oncology Nurses (APHON) – 3,600 members
  • Association of Rehabilitation Nurses (ARN) – 5,600 members
  • Emergency Nurses Association (ENA) – 40,000 members
  • Gerontological Advanced Practice Nurses Association (GAPNA) – 3,100 member
  • Home Healthcare Nurses Association (HHNA)
  • Hospice and Palliative Nurses Association – 12,500 members
  • Infusion Nurses Society (INS) – 6,500 members
  • International Transplant Nurses Society (ITNS) – 1,900 members
  • National Association of Clinical Nurse Specialists (NACNS) – 2,000 members
  • National Association of Directors of Nursing Administration (NADONA) – 21,000 members
  • National Association of Pediatric Nurse Practitioners (NAPNAP) – 8,500 members
  • Nurses Organization of Veterans Affairs (NOVA) – 51,000 members
  • Oncology Nursing Society (ONS) – 37,000 members
  • Wound Ostomy and Continence Nurses Society (WOCN) – 4,000 members

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