The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight

B. Jack, J. Oldham, A. Williams, V. Hillier

Research output: Contribution to conferencePaper

Abstract

Background Palliative care has one of the largest numbers of Clinical Nurse Specialists [CNS] of any specialty. With the publication of the NHS Cancer Plan, Department of Health [2000] this is set to escalate, particularly in the hospital setting. Despite this there is limited evidence of the effectiveness of the CNS. With the current policy emphasis on demonstrable clinical effectiveness, there is an urgent need to establish the value of CNS in the area of Palliative Care [Robbins 1998]. Method This paper presents the quantitative findings of an evaluation study on the impact of the CNS within a palliative care team in a large hospital in the northwest of England. A quasiexperimental design, using a quota sample, investigated 50 patients receiving CNS input and compared outcomes with 50 patients receiving traditional care. Data was collected using the PACA symptom assessment tool [Ellershaw et al, 1995]. Patient and relatives insight into the disease was examined, along with key factors for patients with cancer such as pain, anorexia, nausea, constipation and insomnia. Results and Discussion The group receiving the input from a CNS could be shown to have a greater improvement in their insight in to their disease and a greater reduction in the severity of all the symptoms measured. All these results were shown to be statistically significant, with the single exception of insomnia. In particular pain was found to greatly improve [p<0.001] with CNS showing an improvement of 40.6% more than the patients who received traditional care. The CNS had a positive impact on patients and relatives, with the outcome of greater improvement in both insight and symptoms. This paper will discuss the results and explore potential reasons for this improvement. Intended learning outcomes At the end of the session, participants will be able to: • Be aware of the need to evaluate the impact of the clinical nurse specialist • Appreciate the potential benefits that the CNS within a palliative care team can have for patients and relatives • Have an awareness of the methodological problems that an inherent in researching palliative care patients.
Original languageEnglish
Publication statusPublished - 2003
EventRoyal College of Nursing (RCN) International Nursing Research Conference - Exeter, United Kingdom
Duration: 7 Apr 200210 Apr 2002

Conference

ConferenceRoyal College of Nursing (RCN) International Nursing Research Conference
CountryUnited Kingdom
CityExeter
Period7/04/0210/04/02

Fingerprint

Nurse Clinicians
Palliative Care
Neoplasms
Symptom Assessment
Anorexia
Constipation
England
Nausea
Patient Care
Learning
Pain

Cite this

Jack, B., Oldham, J., Williams, A., & Hillier, V. (2003). The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight. Paper presented at Royal College of Nursing (RCN) International Nursing Research Conference, Exeter, United Kingdom.
Jack, B. ; Oldham, J. ; Williams, A. ; Hillier, V. / The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight. Paper presented at Royal College of Nursing (RCN) International Nursing Research Conference, Exeter, United Kingdom.
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abstract = "Background Palliative care has one of the largest numbers of Clinical Nurse Specialists [CNS] of any specialty. With the publication of the NHS Cancer Plan, Department of Health [2000] this is set to escalate, particularly in the hospital setting. Despite this there is limited evidence of the effectiveness of the CNS. With the current policy emphasis on demonstrable clinical effectiveness, there is an urgent need to establish the value of CNS in the area of Palliative Care [Robbins 1998]. Method This paper presents the quantitative findings of an evaluation study on the impact of the CNS within a palliative care team in a large hospital in the northwest of England. A quasiexperimental design, using a quota sample, investigated 50 patients receiving CNS input and compared outcomes with 50 patients receiving traditional care. Data was collected using the PACA symptom assessment tool [Ellershaw et al, 1995]. Patient and relatives insight into the disease was examined, along with key factors for patients with cancer such as pain, anorexia, nausea, constipation and insomnia. Results and Discussion The group receiving the input from a CNS could be shown to have a greater improvement in their insight in to their disease and a greater reduction in the severity of all the symptoms measured. All these results were shown to be statistically significant, with the single exception of insomnia. In particular pain was found to greatly improve [p<0.001] with CNS showing an improvement of 40.6{\%} more than the patients who received traditional care. The CNS had a positive impact on patients and relatives, with the outcome of greater improvement in both insight and symptoms. This paper will discuss the results and explore potential reasons for this improvement. Intended learning outcomes At the end of the session, participants will be able to: • Be aware of the need to evaluate the impact of the clinical nurse specialist • Appreciate the potential benefits that the CNS within a palliative care team can have for patients and relatives • Have an awareness of the methodological problems that an inherent in researching palliative care patients.",
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Jack, B, Oldham, J, Williams, A & Hillier, V 2003, 'The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight' Paper presented at Royal College of Nursing (RCN) International Nursing Research Conference, Exeter, United Kingdom, 7/04/02 - 10/04/02, .

The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight. / Jack, B.; Oldham, J.; Williams, A.; Hillier, V.

2003. Paper presented at Royal College of Nursing (RCN) International Nursing Research Conference, Exeter, United Kingdom.

Research output: Contribution to conferencePaper

TY - CONF

T1 - The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight

AU - Jack, B.

AU - Oldham, J.

AU - Williams, A.

AU - Hillier, V.

PY - 2003

Y1 - 2003

N2 - Background Palliative care has one of the largest numbers of Clinical Nurse Specialists [CNS] of any specialty. With the publication of the NHS Cancer Plan, Department of Health [2000] this is set to escalate, particularly in the hospital setting. Despite this there is limited evidence of the effectiveness of the CNS. With the current policy emphasis on demonstrable clinical effectiveness, there is an urgent need to establish the value of CNS in the area of Palliative Care [Robbins 1998]. Method This paper presents the quantitative findings of an evaluation study on the impact of the CNS within a palliative care team in a large hospital in the northwest of England. A quasiexperimental design, using a quota sample, investigated 50 patients receiving CNS input and compared outcomes with 50 patients receiving traditional care. Data was collected using the PACA symptom assessment tool [Ellershaw et al, 1995]. Patient and relatives insight into the disease was examined, along with key factors for patients with cancer such as pain, anorexia, nausea, constipation and insomnia. Results and Discussion The group receiving the input from a CNS could be shown to have a greater improvement in their insight in to their disease and a greater reduction in the severity of all the symptoms measured. All these results were shown to be statistically significant, with the single exception of insomnia. In particular pain was found to greatly improve [p<0.001] with CNS showing an improvement of 40.6% more than the patients who received traditional care. The CNS had a positive impact on patients and relatives, with the outcome of greater improvement in both insight and symptoms. This paper will discuss the results and explore potential reasons for this improvement. Intended learning outcomes At the end of the session, participants will be able to: • Be aware of the need to evaluate the impact of the clinical nurse specialist • Appreciate the potential benefits that the CNS within a palliative care team can have for patients and relatives • Have an awareness of the methodological problems that an inherent in researching palliative care patients.

AB - Background Palliative care has one of the largest numbers of Clinical Nurse Specialists [CNS] of any specialty. With the publication of the NHS Cancer Plan, Department of Health [2000] this is set to escalate, particularly in the hospital setting. Despite this there is limited evidence of the effectiveness of the CNS. With the current policy emphasis on demonstrable clinical effectiveness, there is an urgent need to establish the value of CNS in the area of Palliative Care [Robbins 1998]. Method This paper presents the quantitative findings of an evaluation study on the impact of the CNS within a palliative care team in a large hospital in the northwest of England. A quasiexperimental design, using a quota sample, investigated 50 patients receiving CNS input and compared outcomes with 50 patients receiving traditional care. Data was collected using the PACA symptom assessment tool [Ellershaw et al, 1995]. Patient and relatives insight into the disease was examined, along with key factors for patients with cancer such as pain, anorexia, nausea, constipation and insomnia. Results and Discussion The group receiving the input from a CNS could be shown to have a greater improvement in their insight in to their disease and a greater reduction in the severity of all the symptoms measured. All these results were shown to be statistically significant, with the single exception of insomnia. In particular pain was found to greatly improve [p<0.001] with CNS showing an improvement of 40.6% more than the patients who received traditional care. The CNS had a positive impact on patients and relatives, with the outcome of greater improvement in both insight and symptoms. This paper will discuss the results and explore potential reasons for this improvement. Intended learning outcomes At the end of the session, participants will be able to: • Be aware of the need to evaluate the impact of the clinical nurse specialist • Appreciate the potential benefits that the CNS within a palliative care team can have for patients and relatives • Have an awareness of the methodological problems that an inherent in researching palliative care patients.

M3 - Paper

ER -

Jack B, Oldham J, Williams A, Hillier V. The impact of the Clinical Nurse Specialist within a Palliative Care Team in an acute hospital setting, on cancer patients symptoms and insight. 2003. Paper presented at Royal College of Nursing (RCN) International Nursing Research Conference, Exeter, United Kingdom.