Review Article

Improving Palliative Cancer Care

Catherine Del Ferraro, MSN, ED, PHN, RN, CCRP, Betty Ferrell, PhD, FAAN, MA, FPCN, CHPN, Carin Van Zyl, MD, FACEP, Bonnie Freeman, DNPC, RN, ANP-BC, and Linda Klein, JD

City of Hope, Duarte, California

Supported by a grant from the National Cancer Institute 1 PO1 CA136396-0141

Catherine Del Ferraro, MSN, Ed, PHN, RN, CCRP, Division of Nursing Research and Education, City of Hope, 1500 East Duarte Road, Duarte, CA 91010. E-mail: cdelferraro@coh.org


J Adv Pract Oncol 2014;5:331–338 | DOI: 10.6004/jadpro.2014.5.5.3 | © 2014 Harborside Press®


  

ABSTRACT

Over a decade ago, the Institute of Medicine (IOM) presented Ensuring Quality Cancer Care in the United States, with recommendations for change (IOM, 1999). However, barriers to integrating palliative care (PC) to achieve high-quality care in cancer still remain. As novel therapeutic agents evolve, patients are living longer, and advanced cancer is now considered a chronic illness. In addition to complex symptom concerns, patients and family caregivers are burdened with psychological, social, and spiritual distress. Furthermore, data show that PC continues to be underutilized and inaccessible, and current innovative models of integrating PC into standard cancer care lack uniformity. The aim of this article is to address the existing barriers in implementing PC into our cancer care delivery system and discuss how the oncology advanced practice nurse plays an essential role in providing high-quality cancer care. We also review the IOM recommendations; highlight the work done by the National Consensus Project in promoting quality PC; and discuss a National Cancer Institute–funded program project currently conducted at a National Comprehensive Cancer Center, “Palliative Care for Quality of Life and Symptoms Concerns in Lung Cancer,” which serves as a model to promote high-quality care for patients and their families.




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