(1001): Creation of a home care based pain management and palliative care program

Abstract

Due to ongoing changes within our healthcare system, patients with complex pain and palliative care issues are frequently requiring home based nursing care. Although hospice may be an option for some, patients who experience chronic pain or symptoms related to life threatening illness may be initially referred for home care and may not meet hospice criteria. Home care nurses have a unique opportunity to provide quality pain and symptom management to patients in the community. In evaluating patient responses over time and advocating for appropriate palliative care, home care nurses provide an essential link in the continuum of care. Ongoing education and accessibility to a nursing expert in symptom management can assist these professionals in obtaining the knowledge and skills they require to meet these care challenges. In response to this need, Visiting Nurse Services in Westchester, a not-for-profit home health care agency in New York has created a specialized program in pain management and palliative care for home care patients. The program manager is an advanced practice nurse (APN) certified in palliative care. The APN is available for home-based evaluations and provides clinical expertise to staff in creation of an appropriate plan of care. An educational program has been created for designated nurses to obtain knowledge and skills related to pain and palliative care. The pain and palliative care resource nurses (PPCRN) are given the appropriate skill set to provide home based evaluations for patients with a focus on pharmacological and non-pharmacological symptom management. In addition, the PPCRNs can act as a resource to their nursing colleagues. With the establishment of this program, symptoms are addressed in a timely manner and communication with other health care providers positively impacts the quality of life and quality of care patients and their caregivers receive in the home setting.