Improving End-of-Life Care: An Evidence-based Curriculum

Americans are not only living longer, many experience terminal illnesses for extended periods of time. Management of these terminal illnesses and deaths frequently occur in acute care settings where nurses are often the healthcare professional at the bedside. Unfortunately, many nurses caring for older adults who are suffering a terminal illness are unprepared to provide evidence-based, end-of-life (EOL) care due to lack of formal training offered in nursing programs. This gap in knowledge and skills may result in suboptimal clinical care of the dying patient, and insufficient support for their family members. In addition, the unprepared nurse often experiences anxiety and/or fear when caring for these patients (Meeker, 2014, Mallory, 2003). The curriculum in a majority of nursing schools today does not contain focused EOL content (Wallace, et. al., 2009). This is true also for the University of Utah College of Nursing (CoN). With an aging population, this deficiency is becoming increasingly important. Incorporating evidence-based practice (EBP) EOL content into nursing programs will result in a better prepared nursing force to meet this growing challenge. EBP EOL care has the potential to provide greater comfort to patients throughout their terminal illnesses and a more peaceful death. The American Association of Colleges of Nursing, when considering nursing curricular offerings, emphasizes this important principle, "Nurses have a unique and primary responsibility for ensuring that individuals at end of life, experience a peaceful death" (AACN, 1998). The overarching goal for this project was to improve patient care, through development and delivery of a newly created online program focused on EOL care. The curriculum, offered to selected nursing students, was designed to increase the knowledge and broaden the perspective of future nurses when caring for this patient population and their family members. The specific objectives for this IRB approved project were: 1) Develop a curriculum for an online EBP EOL course for the CoN students, 2) Evaluate the EBP EOL curriculum as a pilot for a cohort of 3rd semester nursing students and assess its effectiveness by measuring the attitudes of participating students utilizing a validated pre- and post-questionnaire, and 3) Submit an abstract to be considered for poster and/or podium presentation at a national conference. All objectives were met. The questionnaire results and course evaluation demonstrated that the students following course completion felt better equipped, more confident, and less anxious when managing the dying patient. Their preexistent feelings of empathy were enhanced. Results of the course evaluation provided evidence that the students valued EOL content as part of their nursing education and justify inclusion of focused EOL content in future nursing curricular offerings