Currently the homecare pediatric palliative care (PPC) program is not accepting new patients and there is a lengthy waiting list. This is largely due to limited funding for the PPC as it is currently not viewed as “a money maker.” Therefore, the challenge to the capstone change project is that increasing nurse advocacy could surely result in increased early palliative care consults, but if the program is not supported to expand, how can eligible patients receive these services? If my capstone project proposal is considered, it could directly impact funding for PPC due to the evidence that it can significantly decrease hospitalizations and costs. Indirectly, my capstone proposal could inspire more focused research on our current and previous PPC patients to evaluate for specific cost effectiveness related to the organization of Rady Childrens Hospital and Homecare.
A direct effect of my capstone change project to be considered could be that Oncology nurses via education and skills training in palliative care could improve the quality of care to patients with advanced cancer. With a mere fundamental understanding of the principles in palliative care, the nurse can surely enhance the quality of care provided to patients with advanced cancer (Docherty, Thaxton, Allison, Barfield, & Tamburro, 2012). Even if the capstone change is not adopted into the standard model of Oncology RN education, the power point presentation by this writer can provide important information which can be shared among colleagues. This in turn can have an indirect effect of enhancing the patient’s quality of care. Oncology bedside and clinic nurses are in the unique position to provide basic PPC teaching and care to their high risk patients with advanced cancer. However, as Docherty et al., 2012, report less than 14.000 nurses in the U.S. “have been formally trained in palliative care” (p.77).
Clinically, the change project would directly require integrating the principles and skills of palliative care teaching into the RN residency program and would entail adjustments to the basic standard of care models and charting protocols for Oncology nurses in order to document specific palliative care interventions, advocacy, and family teaching.Indirectly, if there continues to be challenges in expanding the PPC program, potentially more Oncology nurses will need to supplement this gap and increase their formal training in palliative care