PICU Nurses’ Self-Perceived Competency in End-of-Life Care

The majority of pediatric inpatient deaths occur in pediatric intensive care units (PICUs), where registered nurses (RNs) caring for children and their families at the end of life face unique challenges such as differing developmental stages, increased caregiver involvement, and uncertain prognoses. Studies in adult settings have indicated that current palliative care education may not adequately prepare RNs to meet the demands associated with providing end-of-life (EOL) care. Despite significant differences between the EOL care of children and adults, few studies have examined EOL education and competency in pediatric settings. The purpose of this study was to determine current levels of PICU RNs' self-perceived competency in providing EOL care, and to evaluate the effect of previous palliative care education on competency. Twenty-four RNs described their nursing experience and EOL education, and participated in the Scale of End-Of-Life Care in the ICU (EOLC-ICU) questionnaire to assess self-perceived competency across EOL care domains. Previous EOL education was common, but participants who reported previous education did not have higher competency scores than those who did not. On-the-job learning seemed to be more beneficial in increasing competency, as EOLC-ICU scores increased with years of RN and PICU experience, and previous experience providing EOL care. RNs were most confident in providing care related to symptom management, emotional support, and spiritual support, while continuity of care, communication, and decision making had lower competency scores. Further studies with larger sample sizes are needed to provide more information about EOL education and competency in pediatric settings.Bachelor of Scienc