Integrating the Clinical Nurse Specialist Into a Multi-State Hospice in a Large Healthcare System.

Advanced Practice Registered Nurses are increasingly recognized for their role and impact in hospice and palliative care. The Clinical Nurse Specialist (CNS) role is emerging as uniquely suitable for practice and leadership in this setting. The integration of a CNS into the practice of a large, multistate Hospice and Palliative Care program is discussed in this article. A timeline is provided with 4 phases of integration with priorities identified and specific strategies that were implemented to overcome challenges during the process. The value of CNS practice to the organization is highlighted in 3 practice exemplars, showing return on investment in terms of increased patient safety and implementation of evidence-based practice for home infusions, developing nurse confidence through complex case reviews, and reducing staff injuries through developing a Safe Patient Handling program.