Examining the value and roles of palliative care nurse practitioners: A scoping review

Professional Standards and the Role of the Advanced Practice Registered Nurse in Hospice and Palliative Care

“…Domains of Palliative Care and APRN ExpertiseMedical management Assess, diagnose, and formulate treatment plans, involving pharmacologic and nonpharmacologic interventions15 Order and interpret tests and procedures to diagnose symptoms of serious illness Provide treatments aimed at reducing symptoms including pain, anxiety/depression, nausea, constipation, gastrointestinal upset, fatigue, appetite loss, and other symptoms impacting patient quality of life16 Treat of end-of-life symptoms such as shortness of breath, confusion, refractory pain, excess secretions Utilize clinical decision-making skills to balance treatment of illness with patient quality of life Perform rapid evaluation and modify treatment plan for declines in patient condition17 Psychosocialsupport Provide psychosocial support to patients and families. Focus on support around the patient/family experience of serious illness, especially caregiver support, anticipatory grief, and bereavement support Communication Utilize advanced communication skills to illicit patient goals, values, and priorities with regard to their serious illness Possess robust knowledge of state and practice area-specific guidelines and documentation requirements for communicating treatment preference regarding life-supporting or life-sustaining interventions Care coordination Partner closely with primary and disease-specific providers regarding treatment planning Facilitate referrals to other specialty clinicians for symptom evaluation and management such as interventional pain, chronic pain, dermatology, psychiatry, social work Navigate transitions in care, especially transitions to hospice care Education Anticipate and deliver needed education regarding medical condition, treatment, symptom management, and end-of-life process to the patient/family Supply education regarding symptom management, transitions in care, and serious illness communication Provide education on palliative care to students and colleagues…”