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Palliative Care Minor

What is Palliative Care?
Palliative care is “patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.”
(http://www.nationalconsensusproject.org/NCP_Clinical_Practice_Guidelines_3rd_Edition.pdf)

What is the difference between hospice and palliative care?
Hospice and palliative care are similar yet distinct. BOTH types of care:
• Hospice and palliative care are similar yet distinct. Both types of care:
• Focus on people with advanced or serious illness
• Involve patients and families as recipients of care and decision-makers in that care
• Are guided by patients’ and families’ preferences for care
• Aim at enhancing the quality of life for both patients and families
• Are delivered by interdisciplinary teams
• Address the physical, emotional, spiritual, and cultural needs of patients and families.

What sets hospice and palliative care apart in the nursing home is how they are delivered. Guided by the regulations in the Medicare Hospice Benefit, hospice care typically focuses on the last six months of a person's life. Most hospice care occurs in the patient’s private residence, although additional sites include nursing homes and assisted living facilities (recognized by Medicare as the person’s home), and inpatient hospice units (sometimes called “hospice houses”).

Palliative care includes hospice care but is not limited to the last six months of a person's life. It should be offered to any patient with a serious illness or permanent debilitating injury. Medical therapies that are aimed at treating the terminal disease can be delivered along with comfort-focused therapies. For example, a cancer patient could be receiving chemotherapy to cure or slow down the disease while also receiving care from the palliative care team. In the United States, palliative care services typically are delivered by a specialized consultation team operating in an acute care or outpatient setting. However, palliative care also is expanding in other clinical and community settings.

Why should I consider the Palliative Care minor?
Palliative care is evolving specialty that is in high demand. Palliative care is relevant for all types of nursing practice, including gerontology, oncology, pediatrics, home care, mental health. Students who have completed PC minor have represented every MSN program and population foci ranging from pediatrics to geriatrics.

Why is there a demand for palliative care APNs?
The number of palliative care services has grown dramatically in the past decade. In 2000, fewer than 24% of U.S. hospitals had a palliative care program. By 2014, over 80% of hospitals with 50 or more beds had palliative care services. The Veterans Health Administration supports palliative care programs at nearly all of its 151 medical centers. The number of outpatient and community-based programs also is increasing.

The demand for hospice services also has increased. Since the establishment of the Medicare Hospice Benefit in 1983, the number of hospice programs grew exponentially and now serves over 1.5 Americans. (http://www.nhpco.org/sites/default/files/public/Statistics_Research/2014_Facts_Figures.pdf).
There also is a need for palliative care in other clinical settings, including nursing homes. As nearly one-quarter of deaths from chronic illness occur yearly in this setting, and it is expected to rise as the population of older adults continues to grow. Geriatric advanced practice nurses with specialized knowledge in palliative care will be poised to lead the delivery of palliative care in this setting.
This growth creates a demand for qualified APRNs with skills to care for patients and families and to lead interdisciplinary palliative care programs.

Why Penn's Palliative Care Minor?
Penn has nationally and internationally recognized faculty leading research and influencing national agendas and practice. The Penn School of Nursing is among only 20 schools to offer opportunities for specialization in palliative care.

The required curriculum is based on core competencies defined by the Hospice and Palliative Care Nurses Association emphasizing theory and concepts (NURS 557) and evidence-based symptom management (NURS 567).

The Palliative Care Minor is designed to:
• More fully integrate content and approaches that are applicable to a wide variety of clinical settings and patient populations.
• Enhance the alignment of course content and assignments with national core competencies for APRNs specializing in Palliative Care APN role and to better prepare them for clinical practice. For example, several assignments are geared towards improving clinical decision making and communication skills.
• Provide perspectives on the global and national landscape of palliative care as well as the ethical, legal and policy issues intersecting with the practice of palliative care.
• Accent the strength of the interdisciplinary and inter-agency relationships we have within Penn and the greater Philadelphia area. Faculty, guest speakers and preceptors in the program are national leaders and expert clinicians in palliative care.
• Make the program's learning experiences and course assignments more flexible to accommodate adult learners and students with diverse educational opportunities

What are the required courses and when are they offered?
The Palliative Care Minor/Post-Master's Palliative Care Certificate is comprised of two required courses and one elective course. Courses may be taken in any sequence although it is recommended that students complete NURS 557 Principles of Palliative Care first.

Core Courses (2 course units)
NURS557 - Principles of Palliative Care (offered Fall semester, Thursdays, 4:30-7:30pm)
NURS567 - An Evidence-based Approach to Managing Symptoms in Advanced Illness (offered Spring semester, Mondays, 4:30-7:30pm)

Elective Courses (1 course unit)
NURS511 - Loss, Grief and Bereavement (offered Summer semester)
-OR-
NURS525 - Ethical Aspects of Health and Technology
-OR-
NURS536 - Pain Science & Practice (offered as a one week intensive course between Fall and Spring semesters)
-OR-
NURS540 - Current Issues In Health and Social Policy
-OR-
NURS550 - Home Health Care Concepts: Mgmt. & Delivery of Community-Based Care
-OR-
NURS577 - Advanced Practice Issues for Palliative Care Nurses (offered every other summer)

Other courses may be approved as the elective. Please discuss options either with the Program Coordinator or Program Advisor

If I am a current MSN student, how do I enroll in the Palliative Care Minor?
To declare the minor, you must complete the MSN Minor Form, found online here: http://www.nursing.upenn.edu/students/resources/HandbooksFormsPolicies/MSNMinorForm.pdf
Complete the form, listing the courses you plan to take and the semester in which you plan to take them. Discuss your course load with your MSN Program Director to determine what will work best for you. Then sign the form along with your Program Director, scan it and email it either to Mary Ersek (ersekm@nursing.upenn.edu) or Dr. Salimah Meghani (meghanis@nursing.upenn.edu).

Can I take the Palliative Care Minor if I already have a Master’s degree?
Yes, the courses can be taken for either academic or continuing education credit for nurses with a Master’s degree in nursing. Contact the Office of Continuing Education at http://www.nursing.upenn.edu/ce/Pages/Contact_Us.aspx for information about applying, registering, and paying for courses.
Are the course offered online?
At this time, there is no online option for the Palliative Care Minor.

Does the Minor prepare me to take the Hospice and Palliative Care Credentialing Center’s Advanced Certified Hospice and Palliative Nurse (ACHPN®) exam?
We reviewed the Core Curriculum for the Advanced Practice Hospice and Palliative Registered Nurse when we revised the Palliative Care minor in 2009. However, the Minor does not specifically prepare you to sit for the exam (http://hpcc.advancingexpertcare.org/#). In addition, there are minimum palliative care practice hours required to be eligible to take the ACHPN® exam. Our program nor does include a clinical component (http://hpcc.advancingexpertcare.org/competence/aprn-achpn/).

Course of Study

Core Courses (2 course units)
NURS557 - Principles of Palliative Care
NURS567 - An Evidence-based Approach to Managing Symptoms in Advanced Illness

Elective Courses (1 course unit)
NURS511 - Loss, Grief and Bereavement
-OR-
NURS525 - Ethical Aspects of Health and Technology
-OR-
NURS536 - Pain Science & Practice
-OR-
NURS540 - Current Issues In Health and Social Policy
-OR-
NURS550 - Home Health Care Concepts: Mgmt. & Delivery of Community-Based Care
-OR-
NURS577 - Advanced Practice Issues for Palliative Care Nurses


Suggested Plan(s) of Study

[Plan of Study Name]


Program Coordinator
Mary Ersek, PhD, RN, FAAN
ersekm@nursing.upenn.edu

Program Advisor
Salimah Meghani, PhD, MBE, RN, FAAN
meghanis@nursing.upenn.edu

Mailing Address:
Penn Nursing
Claire M. Fagin Hall
418 Curie Blvd.
Philadelphia, PA 19104-4217