Palliative Nursing Summit

On May 12, 2017, the Hospice and Palliative Nurses Association (HPNA), in conjunction with our two affiliated organizations, the Hospice and Palliative Credentialing Center (HPCC) and the Hospice and Palliative Nurses Foundation (HPNF), 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 HPNF. 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 organizations, representing more than 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 teams’ accomplishments follows.

The collaboration among the organizations made several achievements possible, as well as meeting the summit’s objectives. The Palliative Nursing Summit concluded in October 2019. The organizations within the Palliative Nursing Summit will continue the relationships that have developed to promote enhanced health of individuals and the healthcare of our country. The summit assisted in establishing HPNA as the leading nursing organization for hospice and palliative care nurses.

Continuing Initiatives from the Palliative Nursing Summit

In March 2018, the two teams began meeting to work on these initiatives.

Seventeen organizations participated in the Palliative Nursing Summit, collaborating on one or both project teams. Two additional organizations joined—the National Black Nurses Association (NBNA) and VITAS Healthcare. We appreciate the ongoing commitment to these project teams.




Pain Project Team

Polly Mazanec, PhD, ACNP, AOCN, FPCN served 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 Pain Management. Judith Paice, PhD, RN and Patrick Coyne, MSN, APRN, ACHPN, FAAN led the webinar, which was offered to members of all the nursing organizations who participated in the summit and other targeted audiences. More than 1,000 individuals registered for the webinar and more than 500 participated in the program.

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 Healthcare. 

The project team is divided into the four work groups described below. The webinars were sent to all organizations involved in the Palliative Nursing Summit.

Clinical Practice
The Clinical Practice Work Group focused on nurses’ knowledge of appropriate equianalgesic conversions. The work group wrote a manuscript for the American Journal of Nursing (AJN) that is pending publication to reach a large population of nurses caring for those with serious illnesses. [LP2]

Education
The Education Work Group’s focus was to assist nurses with pain assessment and interview skills to address patients’ and families’ fears and concerns about pain medications. The team created a webinar, Opioid Pain Management in Serious Illness: Assessing the Educational Needs of Patient and Families Across the Lifespan, in February 2019. The webinar showcased three case studies, featuring role-modeling nurses who asked pain assessment questions and navigated patient/family responses. ASPMN supported this initiative by providing the videotaping during their September conference. Amy Haskamp, MSN, RN, PCNS-BC, CHPPN, CPON (APHON), Vanessa Battista, MS, RN, CPNP (NAPNAP), and Ellyn Schreiner, MPH, RN-BC, CHPN (ASPMN), led the webinar in conjunction with the HPNA education staff. 

Research

The Research Work Group’s objective was to provide bedside nurses with evidence-based information for use in practice with patients with serious illnesses. A manuscript focusing on the care of the patient with comorbid substance use disorder and serious illnesses was written and is pending publication.

Regulatory/Advocacy

The Regulatory/Advocacy Work Group authored an advocacy letter that was sent to Congress on July 25, 2018, regarding 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 more than 715,000 nurses and other healthcare professionals endorsed the letter.

Advance Care Planning Project Team

JoAnne Reifsnyder, PhD, MSN, MBA, FAAN and Todd Hultman, PhD, NP, ACHPN served as co-chairs of Advance Care Planning (ACP) 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 Healthcare, and the Wound, Ostomy and Continence Nurses Society (WOCN). Team Initiatives that were addressed are as follows.

ACP Campaign for Nurses
The group initiated conversations with communications staff from the Palliative Nursing Summit organizations to help develop an ACP campaign specifically for nurses, called the #ISaidWhatIWant Initiative. This campaign encouraged nurses to lead by example and complete their own ACP. The campaign was launched in October 2018 and ran through January 2019. Find out more at advancingexpertcare.org/acp.

Development of the ACP Task Force
The team created an ACP task force to focus on the review and literature analysis of nurse-led ACP training models. The task force’s goal is to make recommendations regarding the best models for consideration of support. The task force consists of several subject matter experts in ACP. 

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

History of the Palliative Nursing Summit (2017)

The more than 4 million nurses in the United States individually and collectively make significant contributions daily to improve both the health of individuals and the healthcare of our country. Access to quality healthcare 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 healthcare 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. The September 2017 HPNA Clinical Practice Forum (advancingexpertcare.org/clinical-practice-forum) also featured a session on the summit findings.

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

Attending Organizations 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 members
  • 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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