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Continuing Education
Coming Soon
CE Hospice Palliative Care
The course equips registered nurses with practical skills to implement advance directives, POLST, symptom control, opioid titration, grief support, and Medicare hospice regulations across all care settings.
Who Should Take This
It is intended for bedside nurses, case managers, and clinical educators who have at least one year of experience in hospice or palliative care and seek to deepen their competency in regulatory compliance and symptom management. These professionals aim to enhance patient‑centered care in home, inpatient, hospital, and long‑term care environments.
What's Included in AccelaStudy® AI
Adaptive Knowledge Graph
Practice Questions
Lesson Modules
Console Simulator Labs
Exam Tips & Strategy
20 Activity Formats
Course Outline
65 learning goals
1
Advance Directives and POLST
2 topics
Advance directive types
- Identify types of advance directives including living wills, durable power of attorney for healthcare, and healthcare proxy and describe their legal authority.
- Explain the POLST or MOLST paradigm including its scope, portability across care settings, physician signature requirements, and relationship to advance directives.
- Describe the nursing role in advance care planning including initiating conversations, documenting patient wishes, ensuring accessibility of documents, and updating as needed.
- Explain the legal and ethical distinctions between withholding and withdrawing life-sustaining treatment and describe how these relate to advance directive implementation.
- Analyze clinical scenarios involving conflicting advance directives, surrogate decision-maker disagreements, and unclear patient wishes to determine ethically appropriate actions.
Goals of care conversations
- Describe structured goals of care conversation frameworks including REMAP, Serious Illness Conversation Guide, and SPIKES protocol for prognostic disclosure.
- Explain prognostic communication strategies including avoiding false hope, acknowledging uncertainty, and aligning treatment recommendations with patient values.
- Analyze complex goals of care scenarios to facilitate family meetings addressing treatment limitations, code status changes, and transition from curative to comfort care.
2
Symptom Management
2 topics
Pain management in palliative care
- Describe pain assessment in palliative care including use of validated tools for verbal and nonverbal patients and total pain concept encompassing physical, psychosocial, and spiritual dimensions.
- Explain the WHO analgesic ladder adapted for palliative care including non-opioid, weak opioid, and strong opioid steps with adjuvant medication integration.
- Describe opioid initiation and titration in terminal illness including starting doses, breakthrough dosing calculations, dose escalation principles, and opioid rotation indications.
- Analyze complex pain scenarios in terminal patients to determine appropriate opioid dose adjustments, adjuvant additions, and interventional pain management referrals.
Non-pain symptom management
- Identify common non-pain symptoms in palliative care including dyspnea, nausea, constipation, delirium, fatigue, anorexia, and anxiety with their prevalence patterns.
- Describe pharmacological management of dyspnea in terminal illness including opioids for breathlessness, anxiolytics, bronchodilators, and oxygen therapy decision-making.
- Explain management of nausea and vomiting in palliative care including etiology-based antiemetic selection, bowel obstruction management, and medication route considerations.
- Describe palliative management of delirium including reversible cause identification, non-pharmacological interventions, antipsychotic use, and terminal delirium recognition.
- Analyze multi-symptom palliative care scenarios to prioritize symptom management interventions and balance medication benefits against side effect burden.
- Describe fatigue management in palliative care including activity pacing, energy conservation techniques, pharmacological interventions, and expectation management.
3
Opioid Titration in Terminal Illness
1 topic
Advanced opioid management
- Explain the principle of double effect as it applies to opioid use in terminal illness and distinguish appropriate symptom management from euthanasia.
- Describe opioid management at end of life including continuous infusions, patient-controlled analgesia, transdermal delivery, and subcutaneous administration routes.
- Explain palliative sedation therapy including indications for refractory symptoms, proportionality principles, informed consent requirements, and monitoring standards.
- Analyze end-of-life pain and symptom crises to determine appropriate opioid dose escalation, route changes, and palliative sedation consideration.
- Describe opioid side effect management at end of life including constipation prophylaxis, antiemetic selection, sedation assessment, and myoclonus treatment.
4
Grief and Bereavement
1 topic
Grief theories and support
- Identify grief theories and models including Kubler-Ross stages, Worden's tasks, Stroebe's dual process model, and continuing bonds theory.
- Describe normal grief responses versus complicated grief including prolonged grief disorder, disenfranchised grief, and anticipatory grief with their clinical features.
- Explain bereavement support interventions including grief counseling referral, support group facilitation, memorial rituals, and follow-up contact programs.
- Describe cultural variations in grief expression, mourning rituals, bereavement practices, and the nursing role in providing culturally sensitive grief support.
- Analyze bereavement risk factors in family members to identify those at risk for complicated grief and recommend targeted support interventions.
5
Medicare Hospice Benefit
1 topic
Eligibility and benefit structure
- Identify Medicare hospice benefit eligibility criteria including terminal prognosis certification, election requirements, and benefit period structure.
- Describe the four levels of hospice care: routine home care, continuous home care, general inpatient care, and respite care with their service specifications.
- Explain hospice recertification requirements, revocation procedures, live discharge criteria, and the relationship between hospice and curative treatment coverage.
- Describe hospice medication coverage rules including the comfort medications formulary, related versus unrelated diagnosis medications, and prior authorization processes.
- Analyze patient eligibility scenarios to determine appropriate hospice referral timing, benefit level selection, and documentation for certification requirements.
6
IDT Team Roles
1 topic
Interdisciplinary team
- Identify the core members of the hospice interdisciplinary team including physician, nurse, social worker, chaplain, aide, volunteer, and bereavement counselor.
- Describe the nursing role in the hospice IDT including care coordination, symptom assessment, patient and family education, and IDT meeting participation.
- Explain the roles of hospice social workers and chaplains in addressing psychosocial distress, spiritual needs, advance planning, and family support during terminal illness.
- Describe volunteer program requirements including training, supervision, documentation, and the role of volunteers in providing companionship and respite support.
- Synthesize an interdisciplinary care plan for a hospice patient incorporating nursing, social work, chaplaincy, and volunteer services aligned with patient goals.
7
Active Dying and Death
1 topic
Signs of approaching death
- Identify the signs and symptoms of actively dying including Cheyne-Stokes respirations, mottling, decreased urine output, restlessness, and altered consciousness.
- Describe comfort care during active dying including repositioning, oral care, discontinuation of unnecessary medications, and family presence facilitation.
- Explain management of death rattle including anticholinergic medications, positioning, suctioning considerations, and family education about terminal secretions.
- Describe post-death care including death pronouncement, body care, notification procedures, organ and tissue donation assessment, and supporting family at the bedside.
- Analyze actively dying patient scenarios to determine appropriate symptom management, family support needs, and comfort measure adjustments during the final hours.
8
Palliative Care Across Settings
1 topic
Palliative care delivery models
- Describe the distinction between palliative care and hospice care including timing of initiation, concurrent curative treatment, and prognostic requirements.
- Explain palliative care delivery models including hospital consultation teams, outpatient clinics, community-based programs, and integration into primary care settings.
- Describe palliative care screening tools including the Surprise Question, NECPAL, and primary palliative care triggers for identifying patients who would benefit from referral.
- Analyze patient scenarios to determine appropriate timing for palliative care consultation versus hospice referral based on disease trajectory and treatment goals.
- Synthesize a palliative care program implementation plan for a hospital including needs assessment, champion identification, outcome metrics, and sustainability strategies.
9
Ethical and Legal Issues
1 topic
End-of-life ethics
- Identify ethical principles relevant to end-of-life care including autonomy, beneficence, nonmaleficence, justice, and their application to treatment decisions.
- Describe moral distress in end-of-life nursing including sources, manifestations, coping strategies, and organizational support mechanisms for affected clinicians.
- Explain the ethics consultation process including when to request ethics committee involvement, committee composition, and how recommendations are communicated and implemented.
- Analyze ethical dilemmas in end-of-life care including futility disputes, artificial nutrition and hydration decisions, and surrogate decision-making conflicts.
10
Staff Support and Quality
1 topic
Staff wellness and program quality
- Identify signs of compassion fatigue and burnout in hospice and palliative care nurses and describe contributing factors unique to end-of-life care settings.
- Describe evidence-based self-care strategies for end-of-life care nurses including reflective practice, peer support, memorial services, and professional boundaries.
- Explain hospice quality metrics including CAHPS Hospice Survey domains, HIS quality measures, and CMS Hospice Quality Reporting Program requirements.
- Synthesize a comprehensive hospice and palliative care nursing competency program incorporating symptom management, communication skills, ethical reasoning, and self-care.
11
Pediatric Palliative Care
1 topic
Pediatric end-of-life care
- Describe unique aspects of pediatric palliative care including concurrent curative treatment, developmental considerations, sibling support, and family-centered decision making.
- Explain age-appropriate communication about death and dying with children including developmental understanding of death, therapeutic language, and memory-making activities.
- Identify perinatal palliative care principles including prenatal diagnosis support, birth planning, comfort care for neonates, and parental grief after infant death.
- Describe pain and symptom management differences in pediatric palliative care including weight-based dosing, age-appropriate assessment, and family involvement in care decisions.
- Analyze pediatric palliative care scenarios to determine appropriate goals of care, symptom management priorities, and family support interventions across illness trajectories.
12
Community and Home Hospice
1 topic
Home hospice nursing
- Describe home hospice nursing responsibilities including admission assessment, care plan development, caregiver training, medication management, and on-call response protocols.
- Explain caregiver education for home hospice including medication administration, symptom recognition, comfort measures, emergency protocols, and when to call the hospice team.
- Identify caregiver burden assessment tools and describe respite care options, community support resources, and strategies for preventing caregiver burnout in home hospice.
- Synthesize a home hospice nursing visit plan incorporating symptom assessment, medication review, caregiver support evaluation, and interdisciplinary care coordination.
Scope
Included Topics
- Advance directives, POLST paradigm, and goals of care conversation frameworks.
- Pain management in palliative care including WHO ladder, opioid titration, and interventional approaches.
- Non-pain symptom management including dyspnea, nausea, delirium, and fatigue.
- Opioid management at end of life including double effect, palliative sedation, and route conversions.
- Grief theories, complicated grief, bereavement support, and cultural variations in mourning.
- Medicare hospice benefit including eligibility, levels of care, recertification, and medication coverage.
- Hospice IDT roles, care coordination, and interdisciplinary care planning.
- Signs of actively dying, comfort care, death rattle management, and post-death care.
- Palliative care delivery models, screening tools, and distinction from hospice care.
- End-of-life ethical principles, moral distress, and ethics consultation processes.
Not Covered
- Advanced palliative medicine fellowship-level pain interventions or procedural techniques.
- Oncology treatment protocols beyond understanding disease trajectory for palliative planning.
- Detailed pharmacology of chemotherapy or targeted therapy agents.
- Hospice administration, billing, or compliance beyond clinical nursing understanding.
- Medical aid in dying legislation or practice beyond ethical framework awareness.
CE Hospice Palliative Care is coming soon
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