Exploring the leadership role of the clinical nurse specialist on an inpatient palliative care consulting team.

Demand for palliative care services in Canada will increase owing to an aging population and the evolving role of palliative care in non-malignant illness. Increasing healthcare demands continue to shape the clinical nurse specialist (CNS) role, especially in the area of palliative care. Clinical nurse specialists bring specialized knowledge, skills and leadership to the clinical setting to enhance patient and family care. This paper highlights the clinical leadership role of the CNS as triage leader for a hospital-based palliative care consulting team. Changes to the team's referral and triage processes are emphasized as key improvements to team efficiency and timely access to care for patients and families.

Pain prevalence study in a large Canadian teaching hospital.

Despite the continued evolution of pain management techniques and an increased awareness of the importance of effective pain management, pain continues to be poorly managed. Following an earlier organization-wide pain collaborative, nursing leaders representing acute and palliative pain services together conducted a pain prevalence study. The purpose of this cross-sectional study was to evaluate the prevalence of pain and the level of interference that pain has on patient activities at a large teaching hospital. Two valid pain measurement tools, the short form of the Brief Pain Inventory (SF-BPI) and the short form of the McGill Pain Questionnaire (SF-MPQ), were chosen to be self-administered. The study revealed a pain prevalence of 71% in a mix of 114 medical and surgical adult inpatients. The SF-BPI results indicated that 31.5% of patients reported pain of moderate to severe intensity and that 11.4% of patients reported pain of severe intensity. The Nursing Advisory Council has committed to supporting an annual prevalence study as part of a corporate goal to monitor pain management across the institution. Forthcoming research will focus on including cognitively impaired patients and conducting thorough chart audits of all patients enrolled in the study. This project provided an opportunity for advanced practice nurses who share a common interest in pain, to collaborate in seeking improvements in pain management for hospitalized patients.