Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: a mixed methods sequential explanatory study

Philip Larkin,Eileen Furlong,Teresa Plazo Escribano,Mary Ryder,Kate Frazer,Eileen McGuigan,Michael Connolly,Eileen Carruthers

doi:10.1186/s12904-021-00834-y

Philip Larkin, Eileen Furlong + Show 6 more

Open Access

https://doi.org/10.1186/s12904-021-00834-y

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Abstract

BackgroundSpecial palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting.MethodsThis study was conducted using a mixed methods sequential explanatory approach in two phases; phase 1 involved completion of a study questionnaire (n = 121) and phase 2 involved part-taking in a focus group (n = 6) or individual interview (n = 4).ResultsPhase 1 results indicated that respondents held positive attitudes towards the Specialist Palliative Care Clinical Nurses Specialist (SPC CNS) in relation to clinical care, education and patient advocacy. Phase 2 qualitative findings identified the importance of the role in terms of symptom management, education and support.ConclusionsThis study provides an evaluation of a SPC CNS role since it was established in an acute hospital setting. The evidence indicates that there is a varied understanding of the role of the SPC CNS. The role was seen as an important one particularly in terms of referrals to and support provided by the SPC CNS, as well as recognition of the importance of the role is providing ongoing education to staff.

Highlights

Special palliative care is provided in a range of settings including a patient’s home, a hospice in-patient unit, or an acute hospital
The majority of respondents were aware that specialist in palliative care clinical nurse specialist (SPC Clinical Nurse Specialist (CNS)) was employed in the hospital (99.2%; n = 120) and data identified that over fifty percent of respondents (53.7%; n = 66) had referred a patient to the Specialist Palliative Care (SPC) CNS in the past 12 months
The data indicated that most referrals to the SPC CNS, across all categories were received from nurses with some referrals from other health and social care professional

Summary

Introduction

Special palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting. Specialist Palliative Care (SPC) is provided in a range of care settings including a patient’s home (their primary place of dwelling), an acute hospital, or a hospice in-patient unit. Consistent with the more recent international definition, the CNS role is designed to improve quality of patient care through the application of specialist knowledge and skills to a defined specialist patient population with established diagnoses [4]. While the CNS role in Ireland has defined requirements and standards for educational preparation, it is not supported by a regulatory framework with practice standards [5]

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