If you have trouble reading/receiving this newsletter, click here to view its contents in a web browser

August 2008 Hospice and Palliative Nurses Association News

 HPNA is leading the way to promote excellence in end-of-life nursing by:

1. promoting the highest professional standards of hospice and palliative nursing;  

2. studying, researching and exchanging information, experiences and ideas leading to improved nursing practice;  

3. encouraging nurses to specialize in the practices of hospice and palliative nursing;  

4. fostering the professional development of nurses, individually and collectively;  

5. responding to the changing needs of HPNA members and the populations they represent; and  

6. promoting the recognition of hospice and palliative care as essential components throughout the health care system.

A hearty "Thank You" to our 1,995 HPNA members who participated in the recent membership survey!  The survey results have been disseminated to Standing Association Committees, as applicable, and continue to be reviewed by the HPNA Board of Directors.  More on the survey results will be shared in future e-newsletters.  One of the immediate changes is reflected in this e-newsletter.  Survey comments indicated a need to focus more on the activities of the Association and pertinent clinical information.  Beginning with this issue, we will include standing content such as 'About Us'; 'Practice Matters'; 'Educational Resource Update'; 'Pharmaceutical Update'; 'HPNA is Heard' and more.  Let us know your thoughts about the content or offer your suggestions by emailing us at membership@hpna.org.     

HPNA Standing Association Committees

HPNA has 5 Standing Association Committees to conduct the work of the Board.  These committees of 8 to 10 are led by HPNA member volunteers and include an HPNA Board Liaison.  The Standing Association Committees are the Chapters, Education, Membership, Public Policy and Research Committees.  Read more about each committee's responsibilities by linking here. HPNA members can become involved by submitting a Project Volunteer Form (located in the Members Only area of the HPNA website) or by contacting the National Office at 412-787-9301 to request the form.   

Christine Dusenbery RN CHPN, Chapters Committee Chair says: "The Chapters Committee supports the mission and growth of HPNA national through the development and growth of integrated chapters. Exploring the term, "growth of integrated chapters," is key to understand the work of the HPNA Chapters Committee.  

Growth – "the process of becoming larger and more mature through natural development." The Chapter's Committee is comprised of District Leaders from all around the country.  District Leaders provide support and guidance to forming provisional groups. The committee members review and approve the charter of new chapters.  

Integrated – "made up of aspects or parts that work well together." In partnership with the HPNA Board and staff, District Leaders provide networking, education, and camaraderie to chapter representatives during the annual HPNA Leadership Weekend.  District Leaders help chapters work together by providing chapter leaders with suggestions on problem solving, future leadership development, and membership strategies.  

Chapter – "a branch of a society or organization." The long range goal of the HPNA Chapters Committee is to have a HPNA Chapter in every state in the United States. We are well on our way!"  

Link here for chapter and provisional group contacts.

Practice Driver

HPNA Practice Drivers help keep you up-to-date on evidence-based practice. They are summaries of research articles on a variety of clinical topics downloaded onto a 'flash drive' for portability. Each article is succinctly condensed to give you just the information you need to practice. Included also is a list of Practice Points which recap the "take to practice" points from the articles. A collection of three topics are selected each quarter and placed on the flash drive. Each topic is prepared as a PDF file which can be printed and shared with colleagues.  Educator colleagues are using them to provide evidence-based support during discussions of clinical practice.  Look for a new Practice Driver each season of the year!  

Winter 2008 contains article summaries of:

• Enteral Feeding in Patients with Neurogenic Dysphagia
• Management of Terminal Secretions
• The Use of Opioids and Sedation at End of Life

Spring 2008 contains article summaries of:

• Cancer-related Fatigue
• Cancer-related Constipation
• Cancer-related Depression

Click here to order a HPNA Practice Driver

(HOW and WHERE you are being represented by HPNA)

HPNA has signed the following JOINT DECLARATION:

The International Association for Hospice and Palliative Care (IAHPC), the Worldwide Palliative Care Alliance (WPCA) and different organizations from around the world has issued a Joint Declaration and Statement of Commitment calling for the recognition of Palliative Care and Pain Treatment as Human Rights. The Declaration and Statement have been jointly developed and signed by representatives of several international and regional organizations from Africa, Latin America, Eastern Europe, Western Europe, Asia and North America. The Declaration was presented on Monday, August 4th at the XVII International AIDS Conference in Mexico City.  

This is the first time that a Joint Declaration has been developed and signed by a collection of leading international organizations in the field of palliative care, hospice, pain, cancer, HIV/AIDS and others.   

According to data from the World Health Organization (WHO) and the International Narcotics Control Board (INCB), only a minority of the more than 1 million people who die each week receive palliative care to alleviate their suffering. Developing countries, which represent about 80 percent of the world's population, account for only about six percent of global consumption of morphine, a mainstay therapy for palliative care and pain control.   

The seven goals in the Declaration are:  

1/ Identify, develop and implement strategies for the recognition of palliative care and pain treatment as fundamental human rights.  

2/ Work with governments and policy makers to adopt the necessary changes in legislation to ensure appropriate care of patients with life-limiting conditions.  

3/ Work with policy makers and regulators to identify and eliminate regulatory and legal barriers that interfere with the rational use of controlled medications.  

4/ Advocate for improvements in access to and availability of opioids and other medications required for the effective treatment of pain and other symptoms common in palliative care, including special formulations and appropriate medications for children.  

5/ Advocate for adequate resources to be made available to support the implementation of palliative care and pain treatment services and providers where needed.  

6/ Advocate for academic institutions, teaching hospital and universities to adopt the necessary practices and changes needed to ensure that palliative care and pain positions, resources, personnel, infrastructures, review boards and systems are created and sustained.  

7/ Encourage and enlist other international and national palliative care, pain treatment, related organizations, associations, federations and interested parties to join this global campaign for the recognition of palliative care and pain treatment as human rights.  

To read the full Declaration, Link here

Partners Against Pain^® is a web-resource that serves patients, caregivers, and healthcare professionals to help alleviate unnecessary suffering by advancing standards of pain care through education and advocacy. Link here

Update on Palliative Care and Hospice for Chronic Kidney Disease Patients
By Linda Gorman, RN, MN, CNS-BC, CHPN, OCN

In the title you will notice the use of Chronic Kidney Disease (CKD) rather than the often used ESRD (End Stage Renal Disease).  Stage 5 CKD is defined as a glomerular filtration rate (GFR) of less than 15ml/minutes (normal GFR is >90ml/min) and is equivalent to ESRD.  The nephrology field has stopped using ESRD in favor of the new classification.   

It is now recognized that CKD patients have been underserved by palliative and hospice programs.  Traditionally hospice has mainly been used when patients stopped dialysis.  We also know that the percentage of these patients who received the hospice benefit has been lower than expected.   NHPCO is currently working with fiscal intermediaries to improve prognostic criteria for CKD with the hopes of increasing access to hospice and palliative care for these patients. (NHPCO Newsline, June 08)  Palliative care and hospice programs have a lot to offer CKD patients who tend to have many symptoms and may be in need of advance care planning.   

There has been a proliferation of resources for promoting good end of life care for the nephrology patient.  Here are 2 excellent web sites that offer resources for dialysis centers as well as palliative care and hospice programs:  

Kidney End-of-Life Coalition

Promoting excellence ESRD workgroup

Representatives from nearly 40 diverse groups identifying the best practices in caring for end-of-life patients from different cultural and religious groups.  

September 5-6, 2008

Hilton Pittsburgh, 600 Commonwealth Place, Pittsburgh PA

Download conference brochure (pdf file).    Register Online for this event.

The 2009 Annual Assembly sponsored by the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association will be held March 25 – March 28, 2009 in Austin, Texas.    

The call for Research Based topics is open through August 18, 2008.Link here

The Generalist Clinical Review Train-the-Trainer programs will be conducted on:

1)  Saturday, Sept. 20, 2008 at the Hyatt Regency, Dearborn, Michigan and

2)  Wednesday, Mar. 25, 2009 at the Austin Convention Center, Austin, Texas.  

Read More

Must pre-register; call HPNA at 412-787-9301   

Professional Nurse Caring for Elders in their Final Days-aimed toward assisted living & LTC facilities (Wed. Sept. 10, 2008 3 pm ET)

Journal Club The Spiritual Care Perspectives and Practices of Hospice Nurses (Wed. Aug. 20, 2008 3 pm ET)

Nursing Assistant Caring for Individuals with HIV at EOL (Wed. Aug. 27, 2008 3 pm ET)

• New Position Statement:  Role of Palliative Care Nursing in Organ and Tissue Donation

• Five Revised Position Statements:  
  1) Complementary Therapies in Palliative Care; 
  2) The Ethics of Opiate Use within Palliative Care; 
  3) Pain Management; 
  4) Palliative Sedation; 
  5) Shortage of Registered Nurses

Applications are being accepted for Spring 2009 HPNA Conference Scholarships.  These can be used for the AAHPM/HPNA Annual Assembly March 25-28, 2009.  

Conference Scholarship Link  

Certification Exam Scholarships are one member benefit offered by HPNF.  HPNA members who pass an NBCHPN exam taken between June – November are eligible to apply by December 1.  Certification Exam Scholarship Link

NBCHPN Monthly Update  Link here

A website supported by Novartis to educate about Iron Overload is newly launched.  Their goal is building a nationwide community of Iron Overload Nurse Ambassadors to help prevent IO at-risk patients.  Read More

    Quarterly enewsletter Link here

The National Consensus Project for Quality Palliative Care (NCP) announced the inauguration of the NCP Quality in Palliative Care Award, a program designed to recognize organizations performing superior work incorporating the NCP's Clinical Practice Guidelines for Quality Palliative Care (http://www.nationalconsensusproject.org) into their palliative care services.  

Application deadline is September 1, 2008.  For more information contact Ken Zuroski by email at kenz@hpna.org or phone 412-787-1002. Link for further information

The Center to Advance Palliative Care (CAPC) and the American Academy of Hospice and Palliative Medicine (AAHPM) are pleased to offer an audio conference on "Billing and Coding for Palliative Care Consultations: Getting Paid for What You Do." Physicians, nurses, social workers, financial managers, administrators, billing coordinators, and medical directors of palliative care programs are invited to participate.  

For more information and to register visit www.capc.org/support-from-capc/audio-conf/09-17-08/.

If you are not receiving the publications included with your membership, please contact us.  The mailing lists for Journal of Hospice and Palliative Nursing, the HPNA Nursing Assistant Newsletter, etc. are all prepared from our database at the National Office.  The journals are sent second class mail and are not forwarded.  Please keep us informed of your address changes so that you receive full benefit of your membership.  The Members Only area of the HPNA website has been enhanced to permit current members to edit personal contact information: address, phone number, email address etc.  Change your contact information at Member Login or call us at 412-787-9301.  Thank you.