An End-of-Life Care Educational Series to Improve Staff Knowledge and Comfort Levels

Abstract

Nursing staff play a key role in enhancing a patient's quality of life during end of life; however, they perceive lack of knowledge to be the largest barrier in providing quality end-of-life (EOL) care. Literature suggests that implementation of palliative and EOL care education can improve nursing EOL care practices. In order to address the gap in nursing knowledge and comfort, a quasi-experimental study was conducted; this study included the implementation of a multimodal EOL care educational series on an inpatient pediatric hematology oncology floor over 6 months. Prior to implementation, nursing staff completed a survey to measure perceived knowledge and comfort level regarding EOL care. The series included didactic sessions, in-services, case studies, practice exercises, and interactive discussions led by an interprofessional team of nurses, child-life specialists, and social workers. Educational topics included EOL symptom management, child-life services, supportive care resources, COMFORT communication, and an End-of-Life Nursing Education Consortium course. Following the educational series, the survey was repeated. Results of the survey demonstrated an increase in nursing knowledge and comfort levels. Significant improvements were observed across several items including medication management of dyspnea (χ 2 1,83 =5.1, P = .023), comfort with implementing interventions (χ 2 1,93 = 3.9, P = .049), and knowledge of hospital resources (χ 2 1,93 = 6.1, P = .014). These results suggest that while EOL education strategies can vary, a combination of learner engagement tactics can increase knowledge and comfort regarding EOL concepts and potentially positively impact nursing practice.

Testing a Pediatric Palliative Care Education Workplace Intervention

“…[11][12][13] One study found that training offered for 6 months via multiple delivery forms was successful in improving nursing knowledge of and comfort with end-of-life care. 10 Similarly, a study by Chrastek et al 12 found that a train-the-trainer End-of-Life Nursing Education Consortium (ELNEC) course improves knowledge of pediatric palliative care. Three studies also found that their education improved nursing practice through increased knowledge of pediatric palliative care practices (ie, symptom management) and intent to make practice changes.…”

“…A variety of education delivery methods were used in the studies. One study used multiple methods of education delivery (ie, in-services, case studies, and interactive discussions) to educate pediatric hematology/oncology nurses on end-of-life and palliative care 10 . Three studies explored the impact of in-person and online pediatric palliative care courses on nursing practice, nursing knowledge, or practice change 11-13 .…”

“…Three studies explored the impact of in-person and online pediatric palliative care courses on nursing practice, nursing knowledge, or practice change 11-13 . One study found that training offered for 6 months via multiple delivery forms was successful in improving nursing knowledge of and comfort with end-of-life care 10 . Similarly, a study by Chrastek et al 12 found that a train-the-trainer End-of-Life Nursing Education Consortium (ELNEC) course improves knowledge of pediatric palliative care.…”

Development of an Institution-Wide Pediatric End-of-Life Summit

“…[3][4][5][6][7][8] Literature shows that instruction on how to provide this type of care increases the skill and competence of clinicians who provide it. 8 In addition, after receiving pediatric palliative care training, health care staff perceive decreased levels of suffering in patients and their families at end of life. 9 Clinicians provide more culturally sensitive care when they assess and respect family values, beliefs, and traditions related to health and illness.…”

“…Research indicates that providing high-quality EOL care requires substantive staff training 3-8 . Literature shows that instruction on how to provide this type of care increases the skill and competence of clinicians who provide it 8 .…”