The Ferrell/Virani Article Reviewed


Palliative care for patients and their families across the cancer disease trajectory-from diagnosis, through survivorship, to end of life-is essential for quality cancer care.

Palliative care for patients and their families across the cancer disease trajectory-from diagnosis, through survivorship, to end of life-is essential for quality cancer care. In their excellent article, Ferrell and Virani emphasize the important role of oncology nurses in providing palliative care, and they present the National Consensus Project (NCP) Guidelines[1] and the National Quality Forum (NQF)[2] preferred practices as a roadmap for all oncology nurses to use in their practice.


The authors succinctly condense the NCP guidelines and NQF preferred practices into a format that is readable and clinically applicable for both the generalist The Ferrell/Virani Article Reviewed and the advanced oncology nurse.


They discuss the NCP's eight domains of palliative care: (1) Structure and Process of Care; (2) Physical Aspects of Care; (3) Psychological and Psychiatric Aspects of Care; (4) Social Aspects of Care; (5) Spiritual, Religious, and Existential Aspects of Care; (6) Cultural Aspects of Care; (7) The Imminently Dying Patient; and (8) Ethical and Legal Aspects of Care. In their discussion, they present preferred practices within the context of oncology nursing practice.


For each domain, key recommendations are nicely summarized and examples of NQF Preferred Practices that correspond to the individual domains are provided. Finally, for each domain, the authors discuss implications specific to oncology nursing, making the guidelines and practices clinically relevant. Recommendations for Domain #3, Psychological and Psychiatric Aspects of Care, are especially well done.


For readers who are interested in the complete NCP Guidelines and NQF Preferred Practices, Ferrell and Virani direct them to appropriate web sites and a variety of helpful additional resources. This is an exciting time to be an oncology nurse, with national efforts improving the practice of palliative care for our patients with cancer and their families. In the past 10 years, many educational programs have been developed and presented nationwide for health care team members, especially for professionals in oncology.


ELNEC (End of Life Nursing Education Consortium) programs, and in particular ELNEC-Oncology, are empowering nurses with the tools to improve the care of patients and families coping with cancer and other life-threatening illnesses across all health care settings.[3]


We are grateful to Betty Ferrell, Rose Virani, and colleagues at City of Hope and the American Association of Colleges of Nursing (AACN) for the ELNEC curriculum and for their dedication to improving palliative care through their research, publications, and national and international education efforts. Now, with the educational tools provided, we as oncology nurses must advocate to integrate the NCP guidelines and the NQF preferred practices into our work settings. These guidelines and preferred practices set the benchmark to which we all should be held accountable. Ferrell and Virani give us the roadmap to follow, so that we can continue to make a difference in the quality of the life of our patients and families.


The author has no signifi cant fi nancial interestor other relationship with the manufacturers of any products orproviders of any service mentioned in this article.




National Consensus Project for Quality Palliative Care:Clinical practice guidelines for palliative care, 2004. Availableat:

. Accessed January 18,2008.


National Quality Forum. Available at:

. Accessed January 18, 2008.


End-of-Life Nursing Education Consortium (ELNEC).ELNEC Project, Copyright © 2000, City of Hope and AmericanAssociation of Colleges of Nursing. Available at:

. Accessed January 18, 2008.

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