ONE MEASURE OF NURSING EXCELLENCE is achieving specialty certification, which denotes a more advanced level of knowledge and practice. THE CERTIFICATION BOARD Perioperative Nursing (CBPN) provides specialty certification for perioperative nurses. The organization's mission is to be the leader in competency credentialing and education that promotes safe, quality patient care in the perioperative arena. THIS ARTICLE PRESENTS study findings regarding the perceived value of a barriers to obtaining certification.

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• Personal care and support • Night careAlthough the elements of service are provided by different providers, they work together to ensure care is seamless 24/7. Outcomes The GCP was commissioned as a "test and learn project"; now in it's 3 rd year, the service has developed in response to local need and resources have been flexibly allocated to provide responsive, high quality care.Each provider has signed up to the success of the project and each has an equal stake in ensuring that the service meets its key performance indicators.The project has succeeded in supporting an increase in home and hospice deaths and a reduction in hospital admissions, length of stay and deaths. Application to hospice practice The model and contracting arrangements have attracted National interest amongst Hospices and commissioners, and has been cited as a model of good practice for others to build on.Thinking strategically about the role of hospices The GCP model is a natural extension of the Hospice service, producing efficiencies and quality improvements. With the current proposed model for palliative care funding, Hospices will need to take on the role as prime contractors in order to survive.

BackgroundThe hospice out-patient service offers support to patients, carers and the bereaved, we identified that clients presented with problems often poorly recognised or understood. These were significant in creating barriers and impacting on ability to self-manage and maintain independence.AimTo educate and empower through the promotion of self-management skills and coping strategies; using a series of interlinked workshops addressing commonalities of symptoms impacting on everyday living.MethodA rolling programme of workshops was designed, running bi-monthly entitled; ‘SMILE’- Self- Management and Independent Living Everyday. The programme comprises four workshops;· Fatigue management· Sleep and relaxation· Mindfulness and resilience· Movement and exercise.ResultsEach workshop is evaluated with positive feedback being obtained in all areas. The most notable being:· The information and skills I have learnt have helped me now – 76% strongly agree· The information and skills I have learnt will help me in the future – 80% strongly agree.The Well-Being Star Outcome Measure is also used. Areas of particular influence noted were on ‘symptom management’,’ feeling positive’, ‘looking after yourself’ and ‘lifestyle’.Feedback received:· ‘Realising sleep problems are very common and I am not alone!’· ‘giving me insight into multiple causes of fatigue’· ‘being given coping examples’.ConclusionPatients have demonstrated a greater level of empowerment and self-management, seeking additional support. This has included requests for help returning to work, an area of support not previously in high demand. As a result of the positive outcomes there has been an increased referral rate. Attendance at sessions is variable with ‘Fatigue Management’ and ‘Sleep and Relaxation’ being most popular. The programme has been enhanced to offer individual sessions for those not suited to a group setting. Additionally increased promotion is required to encourage carers and bereaved people to recognise ‘SMILE’ is not a patient only programme.