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National Consensus Project’s New Clinical Practice Guidelines and Their Impact on Providers

Individuals who are seriously ill require care that is consistent and continuous across various settings and adheres to the patient’s and family’s wishes. However, patients with serious illness and their family caregivers are seldom able to have their care needs reliably met. This leads to symptom exacerbation crises and emergency department visits and/or repeated hospitalizations. In addition to alleviating stress on the healthcare industry, palliative care offers a solution to meet the increased demand of specialized care that focuses on managing the pain and symptoms of those with potentially life-ending illnesses and meets the goals and care preferences of these patients.

To improve access to this care, The National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care, 4th edition urges clinicians and healthcare organizations to integrate it into the services they provide for all people living with serious illness, regardless of their diagnosis, prognosis, or age. It calls for a major shift in the delivery of palliative care from a focus on specialty care to access for palliative care for all patients with serious illness and their families.

The new edition of the guidelines, released on October 31, 2018, “seeks to ensure that the millions of people living with serious illness, such as heart failure, lung disease and cancer, have access to quality palliative care.”

The guidelines also call for palliative care to be available wherever people receive their care, including: outpatient clinics, cancer centers, long-term care facilities, office practices, homeless shelters, dialysis units, and at home.

The Evolution of National Palliative Care Guidelines

The guidelines were developed by the National Consensus Project for Quality Palliative Care, comprised of 16 national organizations with extensive expertise with palliative care and hospice. Since the guidelines were first released in 2004, they have been revised to reflect the dynamic growth of palliative care and hospice.

The 4th edition includes new recommendations such as:

  • Comprehensive assessment of all patients with serious illness to determine their needs and priority goals;
  • Assessment of family member and caregiver need for support and education;
  • Emphasis on improved coordination of care across the disease trajectory and across all care settings;
  • Provision of palliative care across the life-span, inclusive of pediatrics and geriatrics
  • Need for communication among all those caring for the person, from the palliative care team to the family to other health care professionals and providers of community resources.


What Do These Guidelines Mean for My Organization?

Because specialty palliative care resources are limited, the NCP Clinical Practice Guidelines for Quality Palliative Care (4th ed.) include recommendations for all healthcare professionals to incorporate palliative care principles and practices into the care they provide.

“We realize it may be overwhelming for providers to offer palliative care if they haven’t previously,” said Betty Ferrell, PhD, MA, FAAN, FPCN, co-chair of the guidelines. “That’s why the guidelines provide extensive real-world practice examples to illustrate what quality palliative care can and should look like in the community.”

The new edition of the guidelines focuses on specific clinical and organizational strategies, including:

  • treatment considerations
  • screening and assessment elements
  • tools
  • resources

In addition, the authors have included practice examples to help clinicians understand that these guidelines apply to all clinical settings and apply across the life-span.  Healthcare organizations will choose how to best apply the guidelines criteria based on their patent populations and care settings.

Join Relias and the End of Life Nursing Education Consortium (ELNEC) as we discuss the impact of the newly released guidelines in the webinar, New Wave of Palliative Care: Not Just for Specialists.

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